CN110520065A

CN110520065A - Surgical stapling device with elastically deformable end

Info

Publication number: CN110520065A
Application number: CN201880025432.4A
Authority: CN
Inventors: J·L·哈里斯; R·A·布勒索伊; G·J·巴克斯; J·P·肖瓦尔特; F·E·谢尔顿四世
Original assignee: Ethicon LLC
Current assignee: Ethicon LLC
Priority date: 2017-02-17
Filing date: 2018-02-12
Publication date: 2019-11-29
Anticipated expiration: 2038-02-12
Also published as: US20180235609A1; CN117918915A; JP2020508124A; BR112019016948A2; WO2018152044A1; CN110520065B; EP3363390A2; EP3363390B1; US10828031B2; EP3363390A3; JP7123953B2; BR112019016948B1

Abstract

The present invention provides a kind of surgical instruments comprising main body, axis and end effector, the end effector can be operated with compression, suture and cutting tissue.The end effector includes anvil block and storehouse.The anvil block has bent back ends.The bent back ends can be the power being such as applied to when tissue is clamped between anvil block and storehouse on anvil block from bias bending position flexible deformation, the power when end is withstood forces.The bending of the anvil block and deformable features provide improved visuality and navigability for end effector, especially during the regulation for being related to advancing.

Description

Surgical stapling device with elastically deformable end

Background technique

In some environments, endoscopic surgical instrument is preferred for traditional open surgical device, Because lesser notch can reduce post-operative recovery time and complication.Therefore, some endoscopic surgical instruments may be adapted to pass through Distal end effector is placed on desired surgical site by the intubation of trochar.These distal end effector (examples Such as, inner cutter, grasper, cutter, stitching unstrument, applicator, into device, medicine/gene treatment delivery apparatus and use The energy delivery device of ultrasound, RF, laser etc.) tissue can be engaged in many ways, to achieve the effect that diagnosis or treatment.Inside peep Mirror surgical instruments may include the axis between the handle portions positioned at end effector and by clinician's manipulation.Such axis can make It must be inserted into desired depth and be rotated around the longitudinal axis of axis, to be thus conducive to for end effector to be located in trouble In person's body.It can also be by including that one or more actuated articulation joints or features are further conducive to position end execution Device enables end effector selectively to carry out joint motions or otherwise inclined relative to the longitudinal axis of axis Turn.

The example of endoscopic surgical instrument includes surgical stapling device.Some such stitching unstruments can be operated with grip tissue Layer, cut through the organized layer of clamping, and nail is driven across organized layer, near the cutting end of organized layer by the group of cutting Tissue layer is substantially sealed together.Only surgical stapling device as exemplary purposes is disclosed in following United States Patent (USP): 1989 The U.S. of entitled " the Pocket Configuration for Internal Organ Staplers " of year publication in 2 months 21 is special Benefit 4,805,823；Entitled " the Surgical Stapler and Staple Cartridge " of publication on May 16 nineteen ninety-five United States Patent (USP) 5,415,334；Entitled " the Surgical Stapler Instrument's " of publication on November 14 nineteen ninety-five United States Patent (USP) 5,465,895；The beauty of entitled " the Surgical Stapler Instrument " of publication on January 28th, 1997 State's patent 5,597,107；The United States Patent (USP) 5 of entitled " the Surgical Instrument " of publication on May 27th, 1997, 632,432；The United States Patent (USP) 5,673,840 of entitled " the Surgical Instrument " of publication on October 7th, 1997； The beauty of entitled " the Articulation Assembly for Surgical Instruments " of publication on January 6th, 1998 State's patent 5,704,534；The U.S. of entitled " the Surgical Clamping Mechanism " of publication on September 29th, 1998 Patent 5,814,055；Entitled " the Surgical Stapling Instrument of publication on December 27th, 2005 The United States Patent (USP) 6,978,921 of Incorporating an E-Beam Firing Mechanism "；It sends out on 2 21st, 2006 Entitled " the Surgical Stapling Instrument Having Separate Distinct Closing and of cloth The United States Patent (USP) 7,000,818 of Firing Systems "；Entitled " the Surgical of publication on December 5th, 2006 The United States Patent (USP) of Stapling Instrument Having a Firing Lockout for an Unclosed Anvil " 7,143,923；Entitled " the Surgical Stapling Instrument of publication on December 4th, 2007 The United States Patent (USP) of Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack " 7,303,108；Entitled " the Surgical Stapling Instrument Incorporating of publication on May 6th, 2008 The United States Patent (USP) 7,367 of a Multistroke Firing Mechanism Having a Rotary Transmission ", 485；Entitled " the Surgical Stapling Instrument Having a Single that on June 3rd, 2008 announces The United States Patent (USP) 7,380,695 of Lockout Mechanism for Prevention of Firing "；On June 3rd, 2008 is sent out Entitled " the Articulating Surgical Stapling Instrument Incorporating a Two- of cloth The United States Patent (USP) 7,380,696 of Piece E-Beam Firing Mechanism "；On July 29th, 2008 is issued entitled The United States Patent (USP) 7,404,508 of " Surgical Stapling and Cutting Device "；Publication on October 14th, 2008 Entitled " Surgical Stapling Instrument Having Multistroke Firing with Opening The United States Patent (USP) 7,434,715 of Lockout "；Entitled " the Disposable Cartridge of publication on May 25th, 2010 The United States Patent (USP) 7,721,930 of with Adhesive for Use with a Stapling Device "；October 21 in 2010 Entitled " the Surgical Stapling Instrument with An Articulatable End that day announces Announce 2010/0264193 in the U.S. of Effector "；And on September 20th, the 2012 entitled " Motor-Driven announced Surgical Cutting Instrument with Electric Actuator Directional Control Announce 2012/0239012 in the U.S. of Assembly ".Each of above-cited United States Patent (USP) and U.S. Patent Publication Disclosure be herein incorporated by reference.

Although surgical stapling device referred to above is described in endoscopic surgery, it is to be understood that, it is such Surgical stapling device can also be used in abdominal and/or other non-endoscopic surgeries.Only by way of example, in thorax surgery In operation, surgical stapling device can be inserted by thoracotomy, and thus between patient's rib cage to reach one or more Organ, the thorax surgical operation do not use conduit of the trochar as stitching unstrument.Such operation may include being cut using stitching unstrument Disconnected and closure leads to the blood vessel of lung.For example, can be cut off and be closed logical by stitching unstrument before exteriorizing in thoracic cavity Organotropic blood vessel.Certainly, surgical stapling device can be used in various other situations and operation.

Although having manufactured and used various surgery suturing appliances and associated component, it is believed that before the present inventor also Nobody makes or uses described invention in the following claims.

Detailed description of the invention

It is incorporated to the attached drawing in this specification and formed part of this specification and shows embodiment of the present invention, and It is used to explain this hair together with the detailed description of general description of the invention given above and embodiment given below Bright principle.

Fig. 1 depicts the perspective view of the campaign-styled surgery suturing appliance of exemplary joint；

Fig. 2 depicts the side view of the instrument of Fig. 1；

Fig. 3 depicts the perspective view of the end effector of the opening in Fig. 1 instrument；

Fig. 4 A depicts the sectional side view that the end effector of Fig. 3 is intercepted along the line 4-4 of Fig. 3, wherein percussion beam is in close Side position；

Fig. 4 B depicts the sectional side view that the end effector of Fig. 3 is intercepted along the line 4-4 of Fig. 3, wherein percussion beam is in remote Side position；

Fig. 5 depicts the end cross-sectional figure that the end effector of Fig. 3 is intercepted along the line 5-5 of Fig. 3；

Fig. 6 depicts the decomposition perspective view of the end effector of Fig. 3；

Fig. 7 depicts the perspective view of the end effector of Fig. 3, which is located at tissue and in group It is activated in knitting primary；

Fig. 8 depicts the perspective view of the alternative pattern end effector with angled anvil block and angled storehouse；

Fig. 9 depicts the enlarged side view of the end effector of Fig. 8；

Figure 10 depicts the amplification vertical view of the end effector of Fig. 8；

Figure 11 depicts the perspective view of exemplary surgical suture instruments, which has end effector, should End effector has the end section of curved elastically deformable；

Figure 12 A depicts the enlarged side view of the distal part of the end effector of Figure 11；

Figure 12 B depicts the amplification side view of the distal part of the substitution end effector similar to the end effector of Figure 11 Figure；

Figure 13 depicts the bottom view of the distal part of the end effector of Figure 11, and wherein storehouse is shown in dotted line to show anvil The downside surface of seat；

Figure 14 depicts the side, sectional of the distal part of the end effector of Figure 11 of the line 14-14 interception along Figure 13 Figure；

Figure 15 depicts the end cross-sectional figure that the anvil block of the end effector of Figure 11 is intercepted along the line 15-15 of Figure 13；

Figure 16 depicts the exemplary substitution end effector for being used together with surgery suturing appliance as described herein Distal part enlarged side view, shown with part section to show inner feature；

Figure 17 depicts the decomposition perspective view of the distal part of the end effector of Figure 16；

Figure 18 depicts another exemplary substitution end for being used together with surgery suturing appliance as described herein The enlarged side view of the distal part of actuator is shown with part section to show inner feature；

Figure 19 depicts the decomposition perspective view of the distal part of the end effector of Figure 18；

Figure 20 depicts the exemplary of the end effector for being used together with surgery suturing appliance as described herein and replaces For the enlarged perspective of the distal part of anvil block；

Figure 21 depict the end effector for being used together with surgery suturing appliance as described herein another show The enlarged perspective of the distal part of example property substitution anvil block；

Figure 22 depicts the side sectional view of the distal part of the anvil block of Figure 21；

Figure 23 depict the end effector for being used together with surgery suturing appliance as described herein another show The enlarged perspective of the distal part of example property substitution anvil block；

Figure 24 depicts another enlarged perspective of the distal part of the anvil block of Figure 23；

Figure 25 depict the end effector for being used together with surgery suturing appliance as described herein another show The enlarged perspective of the distal part of example property substitution anvil block；

Figure 26 depicts the side sectional view of the distal part of the anvil block of Figure 25；

Figure 27 depict the end effector for being used together with surgery suturing appliance as described herein another show The enlarged perspective of the distal part of example property substitution anvil block；

Figure 28 depicts another enlarged perspective of the distal part of the anvil block of Figure 27, and a portion is shown in dotted line To show inner feature；

Figure 29 depicts the exemplary of the end effector for being used together with surgery suturing appliance as described herein and replaces For the enlarged perspective of the distal part in storehouse；

Figure 30 depicts the side view of the distal part of the exemplary substitution end effector in the storehouse with Figure 29, is illustrated as It does not organize to capture；And

Figure 31 depicts the side view of the distal part of the end effector of Figure 30, is illustrated as capturing between anvil block and storehouse Tissue.

Attached drawing is not intended to be limited in any way, and is contemplated that various embodiments of the present invention can be more Kind of other modes execute, the mode that may not be shown in the accompanying drawings including those.It is incorporated in this specification and constitutes part of it Attached drawing show several aspects of the invention, and be used to explain the principle of the present invention together with specification；However, should manage Solution, the present invention is not limited to shown clear arrangements.

Specific embodiment

Certain exemplary following explanations of the invention are not applied to limit the scope of the invention.According to showing by way of example Following explanation out, other examples, feature, aspect, embodiment and advantage of the invention for those skilled in the art and Speech will be apparent, and a kind of best mode is contemplated for implementing the present invention.It arrives as will be appreciated, the present invention can have it In terms of he is different and apparent, all such aspects are all without departing from the present invention.Therefore, attached drawing and explanation should be considered as be substantially It is illustrative and not restrictive.

I. exemplary surgical stitching unstrument

Fig. 1 to Fig. 7 depicts exemplary surgical suture and cutting off apparatus (10), the non-joint motions described in Fig. 1 Under state, it is sized to the operative site of the intubation insertion patient across trochar, to execute surgical operation.Only to lift The mode of example, such trochar can be from the abdomens for being inserted into patient between two rib cages of patient or elsewhere.In some feelings Under condition, instrument (10) are used in the case where trochar is not present.For example, instrument (10) can pass through thoracotomy or other classes Type notch is inserted directly into.This exemplary instrument (10) includes the handle portions (20) for being connected to axis (22).Axis (22) is at distal side end It terminates in actuated articulation joints (11), which further couples with end effector (12).It should be appreciated that herein Used in for term such as " nearside " and " distal side " grasp the handle portions (20) of instrument (10) referring to clinician.Cause This, end effector (12) is distally located relative to the handle portions (20) of more nearside.It is also understood that for convenient and clear See, herein knot diagram use space term such as "vertical" and "horizontal".However, surgical instruments in many orientations and positions in make With, and these terms are not intended to be restrictive and absolute.

In some patterns, at least some of teaching content that axis (22) is announced according to following U.S. teaching content is carried out Construction: on August 28th, 2014 entitled " the Surgical Instrument with Multi-Diameter Shaft " announced The U.S. announce 2014/0239038, the disclosure of which is herein incorporated by reference.Content according to the teaching of this article, Other suitable configurations of axis (22) will be apparent for those of ordinary skills.

Once the cannula passage that actuated articulation joints (11) and end effector (12) pass through trochar is inserted into, joint motions Connector (11) can carry out long-range joint motions by joint motions control (13), discribed with the virtual image as shown in figure 1, so that end Portion's actuator (12) can be deflected from the longitudinal axis (LA) of axis (22) with required angle (α).End effector (12) can be from as a result, Required angle or since other reasons reach behind organ or close to tissue.In some patterns, actuated articulation joints (11) end effector (12) can be made to deflect along single plane.In some other patterns, actuated articulation joints (11) energy Deflect end effector along more than one plane.Actuated articulation joints (11) and joint motions control (13) can be according to these Multiple any teaching content with reference in reference in of text reference construct.Alternatively, actuated articulation joints (11) and/or pass Section motion control (13) can have any other suitable configuration.Only by way of example, joint motions control (13) can replace Ground is configured to knob, which surrounds the axis rotation perpendicular to the longitudinal axis (LA) of axis (22).

In some patterns, actuated articulation joints (11) and/or joint motions control (13) are according to following United States Patent (USP) Shen At least some of teaching content please teaching content is constructed and operated: on November 17th, 2015 submits entitled “Surgical Instrument End Effector Articulation Drive with Pinion and Opposing The United States Patent (USP) 9 of Racks ", 186,142, the disclosure of the patent application is herein incorporated by reference.Actuated articulation joints (11) at least some of teaching content that can also be announced according to following U.S. teaching content is constructed and is operated: 2014 years It announces in the U.S. of August 28 days entitled " the Surgical Instrument with Multi-Diameter Shaft " announced 2014/0239038, the disclosure of which is herein incorporated by reference.In view of teaching herein content, joint motions Various other suitable forms that connector (11) and joint control (13) can use are for those of ordinary skills It will be evident that.

This exemplary end effector (12) includes lower jaw (16) and pivotable anvil block (18).In some patterns, under At least some of the teaching content that jaw (16) is announced according to following U.S. teaching content is constructed: on August 28th, 2014 Entitled " the Installation Features for Surgical Instrument End Effector announced The U.S. of Cartridge " announces 2014/0239044, and the disclosure of which is herein incorporated by reference.Anvil block (18) It can be constructed according to following: on August 28th, 2014 entitled " the Integrated Tissue Positioning announced Announce 2014/0239042 introduction in the U.S. of and Jaw Alignment Features for Surgical Stapler " At least some of content teaching content, the disclosure of which are herein incorporated by reference；It announces on August 28th, 2014 Entitled " Jaw Closure Feature for End Effector of Surgical Instrument " the U.S. it is public At least some of the teaching content of cloth 2014/0239036 teaching content, the disclosure of which are incorporated by reference this Text；And/or on August 28th, 2014 entitled " the Staple Forming Features for Surgical announced The U.S. of Stapling Instrument " announces at least some of 2014/0239037 teaching content teaching content, this is specially The disclosure of benefit is herein incorporated by reference.In view of teaching herein content, lower jaw (16) and anvil block (18) can be with The various other suitable forms used will be evident for those of ordinary skills.

Handle portions (20) include pistol grip (24) and closure trigger (26).Closure trigger (26) being capable of direction Pistol grip (24) pivots, so that lower jaw (16) clamping or closure of the anvil block (18) towards end effector (12).Anvil Such closure of seat (18) is provided by closed tube (32) and close ring (33), and the two is in response to closure trigger (26) phase For pistol grip (24) pivot and longitudinally translated relative to handle portions (20).Length of the closed tube (32) along axis (22) Degree extends；And close ring (33) is located at the distal side of actuated articulation joints (11).Actuated articulation joints (11) can be operated to incite somebody to action Longitudinal movement transmits/is transferred to close ring (33) from closed tube (32).

Handle portions (20) also include firing trigger (28).Slender member (not shown) extends longitudinally through axis (22), And in response to the actuating of secondary actuator (28), from handle portions (20) to the longitudinal percussion movement of percussion beam (14) transmitting.Percussion This distal translation of beam (14) makes the tissue clamped in end effector (12) be sewn and cut off, it is as follows will be more detailed Ground description.Then, trigger (26,28) are discharged to discharge the tissue from end effector (12).

Fig. 3 to Fig. 6 shows the end effector (12) of percussion beam (14) Lai Zhihang multiple functions using electron beam form. It should be appreciated that electron beam form is only illustrative example.Percussion beam (14) can take any other suitable form, including but unlimited In non-electrical beamlet form.Such as best seen in Fig. 4 A to Fig. 4 B, the upper pin (38) that beam (14) include horizontal orientation, percussion beam are fired Top cover (44), the middle pin (46) of horizontal orientation and the cutting edge (48) in distal side.Upper pin (38) is positioned in anvil block (18) it in longitudinal anvil block slot (42), and can be translated in longitudinal anvil block slot.Percussion back lid (44) is by making to hit The lower surface that beam (14) extend through lower jaw slot (45) (shown in Fig. 4 B) and are slidably engaged lower jaw (16) is sent out, lower jaw slot is It is formed across lower jaw (16).Middle pin (46) is slidably engaged the top surface of lower jaw (16), thus with percussion back lid (44) it cooperates.Therefore, percussion beam (14) inevitable spaced end actuator (12) during percussion.

The percussion beam (14) of some non-electrical beamlet forms can lack upper pin (38), middle pin (46) and/or percussion back It covers (44).Some such patterns of instrument (10) can be relied solely in close ring (33) or other a certain features, to fire When beam (14) is advanced to distal position, anvil block (18) is pivoted to closed position and anvil block (18) is maintained in closed position. Only as an example, percussion beam (14) and/or related locking feature can according in the teaching content that the following U.S. announces at least Some teaching content are constructed: on August 28th, 2014 entitled " the LockoutFeature for Movable announced The U.S. of Cutting Member of Surgical Instrument " announces 2014/0239041, the disclosure of which It is herein incorporated by reference.Content according to the teaching of this article, percussion beam (14) other the suitable forms that can take for Those skilled in the art will be apparent.

Fig. 3 shows this exemplary percussion beam (14) proximally positioned and the anvil block (18) for being pivoted to open position, thus Unspent nail bin (37) is allowed to be removably attached in the channel of lower jaw (16).Such as best seen in Fig. 5 to Fig. 6, originally show The nail bin (37) of example includes warehouse (70), which shows upper brace (72) and couple with lower part storehouse pallet (74).Such as Fig. 3 In be best shown, vertical slit (49) is formed through a part of nail bin (37).It is same as best shown in Figure 3, Three dog holes (51) are formed to pass through upper brace (72) on the side of vertical slit (49), another group of three dog holes (51) It is formed to pass through upper brace (72) on the other side of vertical slit (49).Certainly, it is possible to provide any other suitable quantity Staple (for example, two rows of, four rows or other quantity).Referring again to Fig. 4 A to Fig. 6, wedge-shaped slides (41) and the driving of multiple nails Device (43) is trapped between warehouse (70) and pallet (74), and wherein wedge-shaped slides (41) are located at staple drivers (43) nearside. Wedge-shaped slides (41) can longitudinally move in nail bin (37)；And staple driver (43) can be vertical in nail bin (37) Ground is mobile.Nail (47) is also positioned in warehouse (70), is located above corresponding staple drivers (43).Specifically, each nail (47) it is vertically driven in warehouse (70) by staple drivers (43), (47) will be followed closely and driven out by the nail hole (51) being connected. As being best shown in Fig. 4 A to Fig. 4 B and Fig. 6, there are inclined cam surfaces for wedge-shaped slides (41), when wedge-shaped slides (41) When being driven through nail bin (37) towards distal side, inclined cam surface presses upwards on staple drivers (43).

In some patterns, at least some of teaching content that nail bin (37) is announced according to following U.S. teaching content into Row construction and operation: on August 28th, 2014 entitled " the Integrated Tissue Positioning and Jaw announced U.S. of Alignment Features for Surgical Stapler " announces 2014/0239042, in the disclosure of the patent Appearance is herein incorporated by reference.In addition to this or alternatively, nail bin (37) can be in the teaching content according to following U.S. Publication At least some teaching content constructed and operated: on August 28th, 2014 announce entitled " Installation Announce 2014/ in the U.S. of Features for Surgical Instrument End Effector Cartridge " 0239044, the disclosure of which is herein incorporated by reference.With reference to teaching herein content, nail bin (37) be can be used Other suitable forms will be obvious to those of ordinary skill in the art.

By promoting closed tube (32) and close ring (33) so that end effector (12) such as Fig. 4 A to Fig. 4 B towards distal side In the case where shown closure, by making upper pin (38) to enter longitudinal anvil block slot (42), percussion beam (14) is advanced into and anvil Seat (18) engagement.Pushing block (80) (shown in Fig. 5) is located at the distal end of percussion beam (14), and is configured to engaged wedge sliding Part (41), so that being advanced through the feelings of nail bin (37) towards distal side in percussion beam (14) when firing trigger (28) is activated Under condition, pushing block (80) pushes wedge-shaped slides (41) towards distal side.During such percussion, fire beam (14) cutting edge (48) into Enter the vertical slit (49) of nail bin (37), so that cutting is clamped in the tissue between nail bin (37) and anvil block (18).Extremely such as Fig. 4 A Shown in Fig. 4 B, intermediate pin (46) and pushing block (80) by activating nail bin in the slit (49) that enters in nail bin (37) together (37), wedge-shaped slides (41) are driven at jack-up contacts upwards with staple drivers (43) generation, then outward by nail (47) It is driven across nail hole (51) and contacts nail with nail shapes pit (53) (shown in Fig. 3) formation on the inner surface of anvil block (18). Fig. 4 B shows the percussion beam (14) being translated to the far side completely after completing cutting and suture tissue.It is also understood that from Fig. 4 A Nail shapes pit (53) are intentionally omitted in view into Fig. 4 B；But nail shapes pit (53) is as shown in Figure 3.It should also manage Solution, anvil block (18) are purposely omitted in Fig. 5.

Fig. 7 shows the end effector (12) being activated by single stroke across tissue (90).As shown, cutting It cuts sword (48) (being occluded in Fig. 7) to have cut through tissue (90), while staple drivers (43) have driven three rows alternately to follow closely (47) to wear Cross the tissue (90) on every side of the cutting line generated by cutting edge (48).In this example, (47) whole and cutting line are followed closely It is oriented substantially parallel, it is to be understood that, nail (47) can be with any suitable orientation positions.In this example, in the first row After the completion of journey, end effector (12) is recalled from trochar, replaces empty nail bin (37), then, end effector with new staple cartridge (12) suture site is reached further to be cut and be sutured again insertable into trochar is passed through.This process repeat into Row, notch and nail (47) until desired amount has been provided.Anvil block (18) can need to be closed to be conducive to be inserted by trochar With recall；And anvil block (18) can need to be opened to be conducive to replace nail bin (37).

It should be appreciated that cutting edge (48) substantially can be driven through tissue with nail (47) during each actuation stroke Tissue is cut off simultaneously.In this example, cutting edge (48) only slightly lags behind the driving of nail (47), so that nail (47) is just being cut Cut the same area that sword (48) are driven through the tissue before tissue, it should be appreciated that this can sequentially be overturned, or be cut Cutting sword (48) can be directly synchronous with adjacent nail.Although Fig. 7 shows the end being activated in two layers (92,94) of tissue (90) Portion's actuator (12), it is to be understood that, end effector (12) can be activated across tissue (90) single layer or tissue it is more In two layers (92,94).It is also understood that being shaped and located for (47) of nail adjacent with the cutting line that cutting edge (48) generate can base The tissue at cutting line is sealed in sheet, thus reduces or prevents the bleeding at cutting line and/or the leakage of other body fluid.In addition, Although Fig. 7 shows end effector (12) actuating in two substantially flat opposite planar layers (92,94) of tissue, answer Work as understanding, end effector (12) can also be in the upper actuating such as a part of tubular structure blood vessel, gastrointestinal tract.Therefore, it does not answer Fig. 7 is considered as, any restrictions are carried out to the imagination purposes of end effector (12).With reference to teaching herein content, wherein can be used The various suitable conditions and program of instrument (10) will be apparent for those of ordinary skill in the art.

In a kind of pattern, instrument (10) provides the motorization to percussion beam (14) and controls.It was announced on August 28th, 2014 Entitled " Distal Tip Features for End Effector of Surgical Instrument " the U.S. it is public It is had shown and described in cloth 2014/0239043 and can be used for providing the example components of the motorization control of percussion beam (14), this is specially The disclosure of benefit is herein incorporated by reference.In addition to the foregoing or foregoing teachings are replaced, it is at least part of motor-driven Changing control can be according to the beauty of entitled " the Motor-Driven Surgical Instrument " issued on July 3rd, 2012 State's patent disclosure 8, at least some of 210,411 teaching content teaching content configure, and the disclosure of which to be to draw It is incorporated herein with mode.In addition to the foregoing or foregoing teachings are replaced, the features to drive percussion beam (14) can be operated It can be configured according at least some of the teaching content of U.S.'s announcement 2012/0239012 teaching content, the disclosure of the patent Content is herein incorporated by reference；And/or according in the teaching content of U.S. Publication No 2012/0239012 at least Some teaching content configure, and the disclosure of which is herein incorporated by reference.In view of teaching herein content, use For those of ordinary skill in the art will in other motor-driven suitable component, features and the configurations for providing percussion beam (14) Obviously.It is also understood that some other patterns can provide the manual actuation to percussion beam (14), so that motor can be saved Slightly.Only by way of example, percussion beam (14) can be according in any other herein cited patent/announcement reference teaching content At least some teaching content activated.

Instrument (10) can also include entitled " the Distal Tip Features in publication on August 28th, 2014 What is shown and describe in the U.S. Publication No 2014/0239043 of End Effector of Surgical Instrument " closes Lock feature portion and locking indicator, the disclosure of which are herein incorporated by reference.Additionally, latch switch and/or It is latched indicator and associated components/functions can be according to the entitled " Electronic of publication on January 12nd, 2010 The teaching content of the United States Patent (USP) 7,644,848 of Lockouts and Surgical Instrument Including Same " At least some of teaching content configure, the disclosure of which is herein incorporated by reference.

Instrument (10) further includes manual Returning switch (116), is configured to act as features of " meeting an urgent need ", allows an operator to It is enough that quickly percussion beam (14) proximally bounces back in firing schedule.In other words, manual Returning switch (116) can be in percussion beam (14) it is actuated manually when only part is promoted towards distal side.Manual Returning switch (116) can be according to disclosed on August 28th, 2014 It announces in the U.S. of entitled " Distal Tip Features for End Effector of Surgical Instrument " At least some of number 2014/0239043 introduction introduction provides further function, and the disclosure of which is with the side of reference Formula is incorporated herein.

When describing the operation of instrument (10), term " pivot " (and the art that " pivot " with based on is similar is used Language) it is not to be read as necessarily requiring to be pivoted movement around fixed axis.In some patterns, anvil block (18) is surrounded by pin The axis that (or similar features) limit pivots, which moves in anvil block (18) towards lower jaw (16) When dynamic, slided along elongated slot or channel.In this type formula, pivot axis is put down along the path limited by slit and channel It moves, and anvil block (18) is pivoted around the axis simultaneously.Additionally or alternatively, pivot axis first can be along Slit/channel sliding, then anvil block (18) has slided into certain apart from back wall around the pivot along slit/channel in pivot axis Axis pivots.It should be appreciated that such sliding/translation pivot movement is comprised in such as " pivot ", " pivot ", " can pivot " etc. in terms.Certainly, some patterns can provide anvil block (18) and surround the axis for being kept fixed and not translating in slit or channel The pivot movement etc. of line.

It should be appreciated that can be according to the teaching content configuration and operation instrument (10) in following United States Patent (USP): United States Patent (USP) 4,805,823；United States Patent (USP) 5,415,334；United States Patent (USP) 5,465,895；United States Patent (USP) 5,597,107；United States Patent (USP) 5, 632,432；United States Patent (USP) 5,673,840；United States Patent (USP) 5,704,534；United States Patent (USP) 5,814,055；United States Patent (USP) 6,978, 921；United States Patent (USP) 7,000,818；United States Patent (USP) 7,143,923；United States Patent (USP) 7,303,108；United States Patent (USP) 7,367,485； United States Patent (USP) 7,380,695；United States Patent (USP) 7,380,696；United States Patent (USP) 7,404,508；United States Patent (USP) 7,434,715；The U.S. Patent 7,721,930；Announce 2010/0264193 in the U.S.；And/or 2012/0239012.As described above, every in these patents One disclosure is herein incorporated by reference.Can provide will below for other exemplary modifications of instrument (10) In be more fully described.Following teaching content may be incorporated into the various suitable methods in instrument (10) for the ordinary skill of this field Personnel will be apparent.Similarly, by following teaching content and the herein cited various teaching content of patent/announcement into The various suitable modes of row combination will be apparent those skilled in the art.It is also understood that following introductions Content is not limited to instrument taught in herein cited patent (10) or device.Following teaching content can be easy to be applied to each Kind other kinds of instrument, the instrument include that will not be classified as the instrument of surgical stapling device.With reference to teaching herein content, It wherein can be using hereafter various other suitable devices of teaching content and situation will be aobvious to those skilled in the art And it is clear to.

II. there is visualization, leading-in end and the exemplary end effector for collecting features

In some cases, it can be possible to it is expected that user is made to be more clearly visible that end effector (12).Specifically, user After end effector (12) are inserted into operative site, the axis (22) of instrument (10) may be rotated during operation.It holds end Row device (12) thus also rotates.When end effector (12) rotation, user may want to see operative site.For example, making User may wish to see the contact surface between tissue (90) and end effector (12) or contact point.Because of end effector (12) it can be rotated around longitudinal axis (LA) relative to handle portions (20), so user is when observing operative site, it can It can see the lower jaw (16) of end effector, rather than anvil block (18).Alternatively, end effector (12) can be rotated to this The position of sample, that is, user is when observing end effector (12), it can be seen that anvil block (18).User is it can be seen that than making The bigger range of the operative site range seen with instrument (10) Shi Suoneng of Fig. 1.For example, it is done in user using equipment It is some to be related in the case where cutting off the surgical operation for being sewed with the vascular that body fluid flows through again, it may be desirable to visually confirm anvil block (18) Vascular to be cut has been completely covered with lower jaw (16), has therefore ensured that actuating primary equipment can cut and suture completely This vascular.In other words, user may want to avoid the case where only some vascular is sutured by cutting.Accordingly, it is possible to close Meaning is the means for taking some visual monitorings and/or feedback, and user is allowed to be able to know that end effector (12) is suitably fixed Position is in operative site, and then user can manipulate end effector, and anvil block (18) and lower jaw (16) is allowed to clamp completely Firmly vascular.A kind of mode of feasible monitoring operative site may include the distal end of improvement with lower jaw (16) and anvil block (18) The visibility of adjacent area.In addition, not only it can be desirable to the visualization of the distal end of end effector (12), but also it can be desirable to Construction end effector (12) so that the distal end of anvil block (18) be configured to anvil block (18) towards lower jaw (16) be closed when, Tissue (for example, big blood vessel) is proximally pressed in the space between anvil block (18) and lower jaw (16).

Fig. 8 shows the exemplary end effector (212) including anvil block (218) and lower jaw (216).It should be appreciated that end Portion's actuator (212) can be used interchangeably with the end effector (12) of instrument (10).End effector (212) can be with instrument (10) It is integrally formed, or alternatively, can be exchanged with the end effector (12) of instrument (10).

Anvil block (218) can be operated to pivot relative to lower jaw (216).Anvil block (218) and lower jaw (216) can be with classes It is similar to the clamping tissue (90) for the clamping that anvil block (18) and lower jaw (16) as shown in Figure 1 execute.End effector (212) is also Including storehouse (237), can similarly operate with storehouse shown in Fig. 3 (37) to be placed in lower jaw (216).It such as can be in Fig. 8 The anvil block (218) seen into Figure 10 has the shape of elongation, and wherein the distal part of anvil block (218) is angled towards storehouse (237) it draws close.

The distal part of anvil block (218) is at an angle to draw close towards storehouse (237), so that the farthest side end of anvil block (218) (219) storehouse (237) are extended beyond towards distal side in the longitudinal direction.However in some patterns, distal end (219) can prolong in the longitudinal direction Stretch with storehouse (237) it is vertical flush at a distance from, or extend to the position of the farthest side point nearside relative to storehouse (237).In addition, anvil Seat (218) is drawn close so that gentle incline is at an angle towards storehouse (237).As best shown in figure 10, anvil block (218), which is included in, connects Tapered side (241) when farthest end (219) of nearly anvil block (218).For example, anvil block (218) is configured to class in fig. 8 It is similar to the skis top reversed.Anvil block (218) with angled shape can make end effector (212) to be easier to be inserted into hand Art position.For example, having the anvil block (218) of the skis end shape of flat grade or reversing when contacting tissue, or mobile When across tissue, anvil block (218) surface can be such that tissue bends, and not cause to damage to tissue.This noninvasive injured tissue deflection can be with It is included in when anvil block (218) is closed towards lower jaw (216) and tissue (for example, big blood vessel) is pressed to anvil block (218) to nearside In space between lower jaw (216).Once being placed in operative site, the angled shape of anvil block (218) can also provide end The dissection knot of the more preferable operability of portion's actuator (212) and the distal end of end effector (212) relative to surgical site The more preferable visibility of structure.Those skilled in the art can easily imagine other properly with reference to teaching herein content The anvil block (218) of form.

Storehouse (237) can be operated to maintain the nail similar with nail (47) shown in Fig. 4 A for driving into tissue. As shown in figure 9, the distal end of storehouse (237) has triangular-shaped profile.Specifically, the distal end of storehouse (237) includes upper cone Shape surface (239) and lower tapering surface (238).Additionally, the distal end of storehouse (237) includes tapered side surface on every side (243).In this example, each tapered side surface (243) of storehouse (237) is usually presented with the side (241) by anvil block (218) Taper alignment.Therefore, as shown in Figure 10, the side surface (243) of storehouse (237) will not be from the longitudinal axis of end effector (212) Line (LA) extends outwardly beyond the side (241) of anvil block (218).Upper taper surface (239) and lower tapering surface (238) In The farthest side end in storehouse (237) closes up.Lower tapering surface (238) limits collimation line (240), once so that user is end Actuator (212) is inserted into operative site, so that it may observe along collimation line (240).Collimation line (240) is along lower conical surface (238) Edge extend.It should be appreciated that the flat shape of lower tapering surface (238) can be and can operate, with allow using Person sees and/or substantially sees the distal end (219) of anvil block (218).Specifically, collimation line (240) with extend longitudinally through The longitudinal axis (LA) of end effector (212) is crossed to form visual angle (θ).

Visual angle (θ) can determine user to the luminosity coefficient of distal end (219).Specifically, user may be remote In front of side end (219), any bar sight of collimation line (240) and longitudinal axis (LA) intersection point is passed through in visual angle (θ) range Observation.For example, with the increase of visual angle (θ), user can proximally vantage point to directly in front of distal end (219) The visibility in region become larger；However, user is before proximally vantage point is to distal end (219) as visual angle (θ) reduces The visibility in the region of side becomes smaller.In some patterns, visual angle (θ) limits the angle greater than 90 degree.In addition, in some patterns In, visual angle (θ) limits the angle greater than 135 degree.Those skilled in the art can be light and easy with reference to teaching herein content Lift other proper angles that view angle theta is imagined on ground.In the pattern shown, user is usually along collimation line (240) or along visual angle (θ) Some other point of view in range, therefore, user is not only it is observed that along the region of collimation line, moreover it is possible to observe visual angle Arbitrary region in (θ) range.The downside of distal end (219) can also slightly justify, and facilitate user and see longitudinal axis (LA) and the intersection point of collimation line (240).

When tissue (90) is clamped between the storehouse (237) of closure and anvil block (218), user can be along collimation line (240) Or the other positions observation in visual angle (θ) range, such as it can be clearly seen that anvil block (218) clamps tissue in what position (90).In addition, user will determine whether tissue is clamped in completely between anvil block (218) and storehouse (237), only determine Tissue is clamped completely, just can ensure that tissue does not spill over the end of end effector (212).It is also possible to anvil block (218) and storehouse (237) degree for clamping tissue (90) is visually presented to user.It should be appreciated that in some cases, end effector (212) it can be rotated before, during or after clamping tissue (90).Therefore, the conical by its shape of anvil block (218) can also allow use Person be easier observe distal end (219), or with distal end (219) substantially adjacent area.The anvil block (218) of taper and storehouse (237) lower tapering surface (238), which combines, can further promote end effector (212) light in a manner of hurtless measure It is inserted into tissue.Further, since end effector (212) has tapered end, user can more easily be held end Row device (212) passes through trochar or other equipment and can operate so that end effector (212) to be directed in operative site.Example Such as, once distal end (219) are packed into trochar by user, the anvil block (218) of lower tapering surface (238) and taper can As leading-in end, the rest part sleeve pipe needle of leading end actuator (212).Content in view of the teachings contained herein, this field Those of ordinary skill will be further understood that, pass through the taper of every side (243) of the two sides (241) and storehouse (237) of anvil block (218) Visual and navigability can be enhanced in design.

In addition to the foregoing, the pattern of end effector (212) and the instrument (10) of merging end effector (212) It can be according at least some of teaching content below teaching content come configuration and operation: the mark of publication on November 17th, 2015 Entitled " Surgical Instrument End Effector Articulation Drive with Pinion and The United States Patent (USP) 9 of Opposing Racks ", 186,142, the disclosure of which is herein incorporated by reference；2014 8 Entitled " the Lockout Feature for Movable Cutting Member of Surgical that the moon 28 was announced The U.S. of Instrument " announces 2014/0239041, and the disclosure of which is herein incorporated by reference；2016 12 Entitled " the Integrated Tissue Positioning and Jaw Alignment Features of the publication of the moon 13 The United States Patent (USP) 9 of for Surgical Stapler ", 517,065, the disclosure of which is herein incorporated by reference； On August 28th, 2014 entitled " the Jaw Closure Feature for End Effector of Surgical announced The U.S. of Instrument " announces 2014/0239036, and the disclosure of which is herein incorporated by reference；2014 8 Entitled " the Distal Tip Features for End Effector of Surgical that the moon 28 was announced The U.S. of Instrument " announces 2014/0239043, and the disclosure of which is herein incorporated by reference；2014 8 Entitled " the Staple Forming Features for Surgical Stapling Instrument " that the moon 28 was announced The U.S. announce 2014/0239037, the disclosure of which is herein incorporated by reference；It announces on August 28th, 2014 The U.S. of entitled " Surgical Instrument with Multi-Diameter Shaft " announces 2014/0239038, The disclosure of which is herein incorporated by reference；And/or it announces on August 28th, 2014 entitled The U.S. of " Installation Features for Surgical Instrument End Effector Cartridge " 2014/0239044 is announced, the disclosure of which is herein incorporated by reference.It can be incorporated into end effector (212) In it is further modification will be described in greater detail below.

III. with the end effector of curved elastically deformable anvil block end

In some regulations, it may be necessary to be cut along tissue or by tissue, wherein more than one cutting sequence is needed It completes the regulation-in other words, is sequentially cut along continuous path.In such regulation, this technology that sequentially cuts can To be defined as " advancing ".By the regulation for being related to advancing, instrument (10) can be placed on to surgical site, start instrument to cut It cuts and sutures, then remove instrument from operative site to be used to install new storehouse (37), and instrument is then put back into operation again At position, to be cut and sutured next time along the same paths for being previously cut and suturing the period.Repeat the mistake Journey is completed until cutting and suturing regulation.As visible in Fig. 4 A to Fig. 4 B and Fig. 7, the distal end configuration of end effector (12) exists Gap is provided between the distal end of anvil block (18) and the distal end of storehouse (37).The gap can be by being when each traveling step starts Tissue provides the hurtless measure space for the distal end into end effector (12) and promotes to advance.

As described above, the distal end configuration of end effector (212) is different from the configuration of the distal end of end effector (12)；Wherein The different configurations of end effector (212) provide different potential advantages.Specifically, the distal end configuration of end effector (212) Navigability can be improved and improve the visible of the relationship between the distal end and adjacent anatomical structures of end effector (212) Property.In addition, the distal end configuration of end effector (212) can by when anvil block (218) is closed towards lower jaw (216) by group It knits in the space being proximally pressed between anvil block (218) and lower jaw (216) and tissue collecting's effect is provided.However, holding All structures of portion's actuator (212) are all rigid in pattern, and the bending configuration of the distal end (219) of anvil block (218) can It can be not suitable for operation of advancing, because distal end (219) may be to not receiving when anvil block (218) is closed towards lower jaw (216) The tissue collected in the space between anvil block (218) and lower jaw (216) causes wound.Therefore, in end effector (212) All structures are all rigid in pattern, and end effector (212) may be most suitable for cutting and suturing operation (for example, blood vessel is horizontal Cut), wherein all to be cut and suture tissue is all collected into the nearside of distal end (219).

In view of the foregoing, it may be desirable to provide the modification of end effector (12,212), which provides end and execute The traveling ability of device (12), the group for improving visuality and end effector (212) associated with end effector (212) Collecting function is knitted, it originally may wound risk associated with the perfect rigidity pattern of end effector (212) without will increase. The following describe several only schematic examples of such modification of end effector (12,212).In the following example, anvil block has There is distal end, which is resiliently biased so that the bending or angled configuration that are similar to distal end (219) is presented； However, the distal end of fexible bias pressure can deflect away from lower jaw in response to enough loads in distal end.In view of this The teaching content of text, it should be understood that providing has the anvil block of the angled distal tip section of elastically deformable can be logical It crosses in terms of tissue navigates to operative site and the navigability benefit of additional levels is provided.In this way, deformable distal side end End part can be deflected or be deformed, and to promote end effector mobile by the smooth and hurtless measure of tissue, especially advanced During operation.Additionally, in anvil block when being not at stress state or being contacted with surrounding tissue with to the inclined of angle position In the case where pressure, compared with using the end effector with straight or non-angular anvil block, tissue capture may be implemented and cut The visualization of enhancing during cutting.In addition, certain journey can be provided by having the anvil block for the distal end for being biased into angle position Tissue collecting's effect of degree, until reaching load point relevant to traveling, rather than with simply between anvil block and lower jaw It is associated to collect relatively small institutional framework.

Figure 11 shows another exemplary instrument (310) for being configured to surgical stapling device.Instrument (310) includes shank Partially (320) and axis (322).Instrument (310) has modular arrangements, so that axis (322) can be from handle portions (320) selectivity Ground removes and could attach to the handle portions.Instrument (310) and instrument (10) are similarly configured, so that instrument (310) are grasped The property made and use are identical as the operability and use described above in relation to instrument (10), wherein the additional function of instrument (310) It is modular arrangements.By its modular arrangements, instrument (310) provides the method for replacement end effector.It can make end This change occurs in actuator to mention to replace the end effector in addition worn, or based on the regulation or user's preference It is configured for different end effectors.In addition to the foregoing or foregoing teachings are replaced, can be used to provide instrument (310) Modular arrangements features can according on September 29th, 2015 publication entitled " Surgical Stapling The U.S. of Instrument with Shaft Release, Powered Firing, and Powered Articulation " Patent application 14/868, at least some of 718 teaching content teaching content configure, and the disclosure of which to be to quote Mode is incorporated herein.Content in view of the teachings contained herein, for provide the instrument (310) with modular arrangements other are suitable Component, features and configuration will be apparent to those of ordinary skill in the art.In addition, in view of the teachings contained herein Hold, it will be appreciated by the skilled addressee that instrument (10) can be modified with binding modulesization configuration, such as relative to instrument (310) or shown or described by other instruments for being incorporated herein by reference.

In the example shown in Figure 11, instrument (310) includes the end effector (312) with anvil block (318), the anvil Seat tool has angled distal end (319).In addition, distal end (319) elastically deformable of anvil block (318).With this side Formula, and as best seen in Figure 12 A and Figure 12 B, angled distal end (319) can be operated with from the first angle position Flexible deformation is to the second position.The second position of angled distal end (319) can be substantially straight in some patterns , but can be angled into a certain degree in other patterns (for example, slightly above or below longitudinal axis (A1)).It should manage Solution, the second position of angled distal end (319) can be by the tissues that capture between anvil block (318) and lower jaw (16) Characteristic (for example, thickness, density etc.) limit.In this example, end effector (312) setting is can be from handle portions (320) on the axis (322) dismantled.Only as an example, the entitled " Surgical announced according on October 1st, 2015 In the teaching content of U.S.'s announcement 2015/0272575 of Instrument Comprising a Sensor System " extremely Few some teaching content, axis (322) can be dismantled from handle portions (320), and the disclosure of which is incorporated by reference Herein.In some other patterns, axis (322) can not be dismantled from handle portions (320).

It should be appreciated that end effector (312), which can be used, replaces end effector shown in FIG. 1 (12).In some types In formula, end effector (312) can be integrally formed with axis (22)；Alternatively, it may be separately formed end effector and then will It is assembled.In some patterns, end effector (312) can be provided for robot system.In such robot system In, the modular shaft (322) with end effector (312) can be attached to a part of robot system for using, and make Handle portions (320) are obtained by the part replacement of robot system.Still in other examples, end effector (312) can fit For being used together in a certain way with robot system, end effector (312) connect with robot system without Connect entire modular shaft (322).Content in view of the teachings contained herein, by the anvil block end with angled elastically deformable End effector is integrated to the other modes in the instrument of user's operation or robot manipulation for ordinary skill people It is obvious for member.

Figure 12 A shows the enlarged side view of the distal end of end effector (312).End effector (312) includes anvil block (318) and lower jaw (16) the as above storehouse (37) about instrument (10) description, is received.Such as described above with respect to instrument (10) , anvil block (318) is pivotly rotated in a manner of identical with anvil block (18) towards lower jaw (16).In the configuration, end Actuator (312) is similar to end effector (12), however, anvil block (318) includes the angled distal side end of elastically deformable It holds (319).As illustrated in fig. 12, end (319) are imparted into the bias of angle position, which shows in Figure 11 It out and is in fig. 12 in dotted line.When end effector (312) does not clamp tissue and opens, end (319) use the angulation Position is spent, as shown in figure 11；Or be closed in the case where no clamping tissue, as in Figure 12 A shown in dotted line.It is held in end In the case that row device (312) is in the angled state or position, it is believed that end effector (312) is not loaded or is in Unloaded state or position.On the contrary, when end effector (312) clamp tissue, it is believed that end effector (312) has added Carry or be in stress state or position.

When closure and the clamping tissue not between anvil block (318) and lower jaw (16), end (319) contact storehouse (37).In this position, downside surface (324) restriction of end (319) is intersected with the longitudinal axis (A1) limited by axis (322) To form the plane of angle (θ 1).When closure and clamping tissue (90) between anvil block (318) and lower jaw (16), end (319) downside surface (324) contacts tissue (90).In this position, the downside surface (324) of end (319) is limited and is indulged The plane of angle (θ 2) is intersected to form to axis (A1).In the example shown in Figure 12 A, angle (θ 1, θ 2) be relative to Longitudinal axis (A1), and the summation of angle (θ 1, θ 2) indicates the motion range of distal end (319) experience.Only it is used as example Rather than limit, in some instances, from longitudinal axis (A1) towards storehouse (37) in downward direction on, angle (θ 1) about 20 with Between about 70 degree, or specifically between about 30 degree and about 50 degree.Only as an example, not a limit, in some instances, From the upward direction of longitudinal axis (A1) far from storehouse (37), angle (θ 2) is between about 0 degree and about 90 degree.Only it is used as example Rather than limit, in some instances, by the motion range of end (319) experience between about 20 degree and about 110 degree.For angle The angle of (θ 1, θ 2) description is merely exemplary and not restrictive.Content according to the teaching of this article, other proper angles for It will be apparent for those skilled in the art.

Additionally, in some cases, longitudinal axis (A1) indicates zero degree reference and can be relative to its angle It is positive or negative.For example, angle along from longitudinal axis (A1) towards storehouse (37) in downward direction in the case where, angle can be by It is characterized as negative angle.Similarly, in the case where angle is along from the upward direction of longitudinal axis (A1) far from storehouse (37), angle can To be characterized as being positive-angle.When using these regulations, the motion range of the distal end (319) due to caused by deformation can be with It is understood to that the angle when distal end (319) are in the position of contact storehouse (37) is in deformation in distal end (319) The summation of the absolute value of the angle of state (when clamping tissue).

Figure 12 B shows another of the substitution end effector (412) similar with the end effector of Figure 12 A (312) Side view.About end effector (312), when anvil block (318) is in its angled and undeformed state (as in Figure 12 A It is shown in dotted line in view) when, anvil block (318) is extended to be flushed or neighbouring position with the distalmost end of storehouse (37).Work as anvil block (318) when being deformed so that it is upward deflected, the end of distal end (319) extends to the distal side of storehouse (37) distalmost end.About End effector (412), as shown in Figure 12 B, when anvil block (318) is in its angled and undeformed state (as in Figure 12 B It is shown in dotted line in view) when, anvil block (318) is extended to be flushed or close point with the distalmost end of storehouse (37).When anvil block (318) When being deformed so that it is upward deflected, the end of the distal end (319) of anvil block (318) extends to neat with the distalmost end of storehouse (37) Flat or close point.In this way, when anvil block (318) is in its angled state or deformation state, end effector (412) anvil block (318) is flushed or is approached with the distalmost end of storehouse (37), so that no matter anvil block (318) is in angled and not Deformation state is in deformation state, and anvil block (318) does not all extend over the distalmost end of storehouse (37).In some cases, This can be by modification anvil block (318) so that the length of the distal end (319) of anvil block shortens to realize.In other situations Under, instrument (10,310) can be modified to provide the slight proximal retraction of anvil block (318) in clamping.In in view of the teachings contained herein Hold, when being related to controlling anvil block (318) position, the other modes for modifying end effector (412) are common for this field Technical staff will be apparent.

A. the anvil block end of molding is coated

Figure 13 to Figure 15 shows the amplification distal view of end effector (312) to show representative configuration.Figure 13 is extremely Construction shown in figure 15 is also applied for end effector shown in Figure 12 B (412), in addition to anvil block above-mentioned (318) length Difference.As shown in the top view of Figure 13, end effector (312) includes anvil block (318), and wherein distal end (319) includes rigid Property part (326) and deflectionable part (328).In this example, deflectionable part (328) is overmolded into rigid element (326) distal end (319) of anvil block (318) is formed on.In the example shown shown in Figure 13, the profile of storehouse (37) with Dotted line shows the downside surface (324) to show anvil block (318).The rigid element (326) of distal end (319) is from anvil block (318) main body (330) extends.In this example, main body (330) consists of metal, and rigid element (326) is metal master Body (330) arrives the extension in distal end (319).In other patterns, main body (330) and/or rigid element (326) can be with Be made of the material in addition to metal, including but not limited to the combination of plastics, ceramics, metal and plastics or ceramics and other Suitable material or combination of materials, content is apparent to those skilled in the art in view of the teachings contained herein for this 's.In addition, rigid element (326) is perfect rigidity in some patterns, but in other patterns, rigid element (326) Extent of elasticity can be lower than deflectionable part (328).

In the shown pattern of Figure 13 and Figure 14, metal part (326) includes generally planar or plane downside surface (332), and similarly generally planar or plane top surface (334).Metal part (326) further includes from top surface (334) opening (336) that metal part (326) arrive downside surface (332) is extended through.Additionally, metal part (326) includes Neck area (338), the head zone (340) extended from neck area (338) towards distal side and neck area (338) with The shoulder (342) of transition position between head zone (340).In this example, master of the neck area (338) from anvil block (318) Body (330) extends.By this arrangement, metal part (326) provides fixed character portion or interface, such as opening (336) and shoulder Portion (342), wherein elastomer portion (328) can be used cladding molding process and be connect with fast way with metal part (326).

Figure 15 show just close to distal end (319) anvil block (318) section view.As shown, anvil block (318) include longitudinal slit (344), six nail forming pits (346) are divided into two groups of every group of three rows.Slit (344) and Nail shapes pit (346) is structurally and functionally similar to the slit (42) described above in relation to anvil block (18) and nail forming Pit (53).Slit (344) includes " t " tee section, as shown in figure 15.Referring again to Figure 13 and Figure 14, in metal part (326) Opening (336) adjacent slots (344) lateral extension portions behavior.Content in view of the teachings contained herein was moulded using cladding Journey is common for this field with the other modes for suitably connecting with elastomer portion (328) to configure metal part (326) It is obvious for technical staff.

Elastomer portion (328) is molded on metal part (326) and is endowed angled match in moulding process It sets, intersects with the plane that the main body (330) by anvil block (318) limits and non-coplanar put down so that elastomer portion (328) is limited Face.In this way, elastomer portion (328), which is formed with, is biased to keep its angled configuration, unless by some other power It is applied on elastomer portion (328), so that it be caused to deviate its initial angle position.In molding process, elastomer Material flows through and fills the opening (336) in metal part (326).Elastomeric material is flowed also around and adjacent to shoulder (342). In this way, elastomer portion (328) is firmly attached during coating molding process with metal part (326).Elastomer Partially (328) may include rubber, plastics or any other suitable natural or synthetic material with desired elastomer properties Material, which allows distal end (318) deformation in stress, but is no longer applying or there are allow the distal end bullet when power Property return to its initial angled state.During molding process, stopper element (not shown) can be inserted in slit (344) To prevent elastomeric material from entering slit (344) in the slit (349) that distal side is formed.Content in view of the teachings contained herein uses packet Molding process is covered to configure elastomer portion (328) with the other modes for suitably connecting with metal part (326) for this It is obvious for the those of ordinary skill of field.

Using the configuration of distal end (319) as described above and as shown in Figure 13 and Figure 14, metal part (326) is to far Extension in the region of side end (319) limits deflecting region (348).The proximal end of deflecting region (348) and distally located end (319) The rigid element of the distal end (319) at place is overlapped.Using the increased region of rigidity, such as illustrated in fig. 12, distal end (319) will deflection, the rest part that wherein deflecting region (348) is used as distal end (319) encloses during deflection to be rotated about Pivoting point or position.Content in view of the teachings contained herein, those skilled in the art will appreciate that modifying distal end (319) to change Become, modification or control deflecting region (348) are so that realize the other modes of the expectation deflection of distal end (319).It below will be into Some such modes are described in detail in one step.

B. with the anvil block end and storehouse in interlocking features portion

In some cases, in the anvil block that end effector includes in conjunction with bending or angled deformable distal end In the case of, features can be integrated in the distal end of anvil block, these features and be integrated in the distal end in storehouse Features cooperate to provide the interlocking features portion for end effector.When in the regulation for being related to advancing or crosscutting When finally being cut in the regulation of blood vessel, this interlocking features portion may be particularly useful.For example, when being grabbed in end effector When histozoic decline, or when catching blood vessel in end effector, the distal end of anvil block is closed and contacts storehouse Distal end.Then, the features of each part can be engaged to provide interlocking features portion.The interlocking features portion can be to making User provides feedback, indicates that grasped tissue or blood vessel are fully captured in end effector.In other cases, when The instrument for using the end effector to configure is directed to operative site and keeping end effector in the closed configuration When, interlocking features portion can be it is useful so that bent back ends are provided through the more preferable operability of surrounding tissue, while to week It encloses tissue and hurtless measure end is presented.As used herein, when being related to the configuration of the distal end of component of end effector, term " angulation Degree " and " curved " synonym for each other should be read as.

Figure 16 and Figure 17 shows combine interlocking features portion as described above exemplary end effector (512) distal end Amplifier section.It should be appreciated that end effector (512), which can be used, replaces end effector shown in FIG. 1 (12), or replace End effector shown in Figure 11 (312).In some patterns, end effector (512) can be integrally formed with axis (22,322)； Alternatively, it may be separately formed end effector and then assembled.In some patterns, as set forth above, it is possible to provide end Actuator (512) is to be used for robot system.

End effector (512) includes anvil block (518), lower jaw (16) and storehouse (537).Lower jaw (16) in structure and Functionally and above with respect to identical described in instrument (10).Lower jaw (16) is configured to selectively receive storehouse (537).Storehouse (537) structurally and functionally similar with above with respect to storehouse (37) described in instrument (10).However, storehouse (537) are in storehouse (537) concave-concave concave portion (538) are combined at distal end (540).Recessed portion (538) each includes undercut feature portion (546). In this example, when forming storehouse (537), the recessed portion (538) with undercut feature portion (546) is molded into distal end (540) in.In other examples, after forming storehouse (537), recessed portion (538) and undercut feature portion (546) machine can be added Work is in distal end (540).

As shown in Figure 16 and Figure 17, this example includes the two separate wells portions (538) longitudinally extended.In addition, each bottom Features (546) are cut also to extend lengthwise into the distal end (540) of storehouse (537).Each undercut feature portion (546) is by each phase A part of recessed portion (538) is answered to limit.In this way, each recessed portion (538) include base portion (542), side wall (544) and Undercut feature portion (546).Notch (548) forms between each recessed portion (538) and connects each recessed portion.Storehouse (537) Residue character category is similar to storehouse as described above (37).

Anvil block (518) includes main body (530) and distal end (519).Distal end (519) has such as above for end The angled configuration that actuator (312,412) shows and describes.In this example, distal end (519) is configured to have rigid The deformable end of property part and deflectionable part (528), these are in the rigid portion for being structurally and functionally similar to anvil block (312) Divide (326) and deflectionable part (328).In some other patterns, distal end (519) can be configured as it is angled, But it is rigid, so that distal end (519) is non-deformable.In order to realize that the deformable end of distal end (519) is matched Set, such as in this example, distal end (519) may with the same way cladding mould that is described above in relation to anvil block (318) It makes in the main body (530) of anvil block (518).For this purpose, forming slit (549) prevents bullet to receive stopper element (not shown) Elastomer material enters the slit of anvil block (518).It is as will be discussed further below, in addition to cladding molding construction described above it Outside, there is also other structures and mode to provide the deformable end configuration of distal end (519).

The distal end (519) of anvil block (518) further includes the door bolt extended from the downside surface (524) of distal end (519) It locks (550).Latch (550) is deformable in this example, and is constructed by elastomeric material.In some patterns, latch It (550) is that the cladding formed during identical molding process when with deflectionable part (528) are formed moulds features.In view of this The teaching content of text, for constructing the other materials of latch (550) and being used to form the other modes of latch (550) for ability It will be apparent for the those of ordinary skill of domain.

Latch (550) includes the hook component (552) on the either side of latch (550).Each hook component (552) is included in door bolt Lock the end (554) in the most proximal end of (550).There are chamfering (557) at each end (554).Latch (550) further includes Void space (556) between each hook component (552).As shown in figure 16, latch (550) is configured to and storehouse (537) Undercut feature portion (546) engagement.This engagement provides the selective interlock between anvil block (518) and storehouse (537).In elasticity Body latch (550) and hook component (552) have under elastic characteristic, when closure end effector (512) is so that anvil block (518) and storehouse (537) when engaging, hook component (552) can be deflected when contacting conical surface (539) of distal end (540).Hook component (552) It may also be deflected when contacting vertical plane (547) of undercut feature portion (546).This deflection will allow anvil block (518) to continue to close Merging allows hook component (552) engagement in undercut feature portion (546).In this example, each hook component (552) includes chamfering (556), conical surface (539) and/or vertical plane (547) are contacted first so as to when engaging anvil block (518) with storehouse (537) Promote the gradually deflection of hook component (552).

From bonding station as shown in figure 16, anvil block (518) can be enough to overcome hook component (552) bias by providing Opening force is separated with storehouse (537), so that they deform and are detached from the undercut feature portion (546) of recessed portion (538).As replacing Generation or supplement, anvil block (518) can be separated by providing the opening force for being enough to make distal end (519) to deflect with storehouse (537), So that hook component (552) and undercut feature portion (546) are detached from.For example, its remaining part of hook component (552) and distal end (519) The deformability divided may be configured so that the rest part than distal end (519) is easier to deflect by hook component (552). In the configuration, hook component (552) will be deflected first so that anvil block (518) and storehouse (537) are detached from.In contrast, hook component (552) and the deformability of the rest part of distal end (519) may be configured so that hook component (552) will be than distal side end Hold the more difficult deflection of rest part of (519).In the configuration, distal end (519) other than hook component (552) Part will be deflected first be finally detached from anvil block (518) and storehouse (537).In addition, hook component (552) and distal end (519) The deformability of rest part may be configured so that hook component (552) will be with the rest part one of distal end (519) Sample is easy deflection.In the configuration, two parts of distal end (519) and hook shape component (552) will all be deflected finally to make Anvil block (518) and storehouse (537) are detached from.

When latch (550) is engaged with undercut feature portion (546), the distal part (558) of latch (550) is configured to fill In the notch (548) for fitting over storehouse (537).Equally, void space (556) is configured to receive separation and limits recessed portion (538) Partition wall (562) portions of proximal (560).In this way, hook component (552) can be sufficiently deep inserted into a longitudinal direction To reach undercut feature portion (546) and finally be engaged with it in each recessed portion (538).Pass through latch (550) and storehouse (537) This configuration of distal end (540), end effector (512) include that four between anvil block (518) and storehouse (537) are complementary special Sign portion.Two such complementary characteristic portions are each hook component (552) and each corresponding undercut feature portion (546), another is mutually The distal part (558) that features are notch (548) and latch (550) is mended, and the 4th complementary characteristic portion is void space (556) and the portions of proximal (560) of partition wall (562).

As described above, and as shown in Figure 16 and Figure 17, interlocking features portion be configured so that undercut feature portion (546) and Engagement between the hook component (552) of latch (550) is machine-direction oriented.In other words, hook component (552) court of latch (550) Prolong longitudinal stretch to the proximal end of end effector (512).Similarly, recessed portion (538) and undercut feature portion (546) are longitudinally prolonged It stretches.Therefore, undercut feature portion (546) are engaged by hook component (552) from longitudinal direction.When anvil block (518) is separated with storehouse (537) When, it is detached from opposite way as described above generation, and this deflection being detached from through the longitudinal axis generation along storehouse (537) And occur.

Figure 18 and Figure 19 shows putting for the distal end of another exemplary end effector (612) in conjunction with interlocking features portion It is most of.It should be appreciated that end effector (612), which can be used, replaces end effector shown in FIG. 1 (12), or replace Figure 11 Shown in end effector (312).In some patterns, end effector (612) can be integrally formed with axis (22,322), or Alternatively, it may be separately formed end effector and then assembled.In some patterns, as set forth above, it is possible to provide end Actuator (612) is to be used for robot system.

End effector (612) includes anvil block (618), lower jaw (16) and storehouse (637).Lower jaw (16) is in structure Functionally and above with respect to identical described in instrument (10).Lower jaw (16) is configured to selectively receive storehouse (637). Storehouse (637) is structurally and functionally similar with above with respect to storehouse (37) described in instrument (10).However, storehouse (637) are in storehouse (637) recessed portion (638) are combined at distal end (640).Recessed portion (638) includes undercut feature portion (646).In this example In, when forming storehouse (637), the recessed portion (638) with undercut feature portion (646) is molded into distal end (640).In In other examples, after forming storehouse (637), recessed portion (638) and undercut feature portion (646) can be machined to distal side end It holds in (640).

As shown in Figure 18 and Figure 19, recessed portion (638) extends lengthwise into the distal end (640) of storehouse (637).Each bottom Cut the distal end (640) that features (646) orthogonally extend to storehouse (637) relative to the longitudinal axis limited by storehouse (637) In.Each undercut feature portion (646) includes base portion (642), side wall (644) and top surface (648).Each top surface (648) limit The fixed plane parallel with the plane that the conical surface (639) by storehouse (637) limits.In this way, each undercut feature portion It (646) include tapered profiles.However, undercut feature portion has outline of straight line with can replace in some other patterns.Storehouse (637) residue character category is similar to storehouse as described above (37).Content in view of the teachings contained herein is used to form recessed portion (638) it will be apparent for those of ordinary skills with the other modes of undercut feature portion (646).

Anvil block (618) includes main body (630) and distal end (619).Distal end (619) has such as above for end The angled configuration that actuator (312,412,512) shows and describes.In this example, distal end (619) is configured to have There is the deformable end of rigid element and deflectionable part (628), these are being structurally and functionally similar to the rigid of anvil block (312) Property part (326) and deflectionable part (328).In some other patterns, distal end (619) can be configured as angled , but be rigid, so that distal end (619) is non-deformable.In order to realize the deformable end of distal end (619) Configuration, such as in this example, distal end (619) may be to coat with the same way described above in relation to anvil block (318) It is molded into the main body (630) of anvil block (618).It is as will be discussed further below, in addition to cladding molding construction described above Except, there is also other structures and mode to provide the deformable end configuration of distal end (619).

The distal end (619) of anvil block (618) further includes the door bolt extended from the downside surface (624) of distal end (619) It locks (650).Latch (650) is deformable in this example, and is constructed by elastomeric material.In some patterns, latch It (650) is that the cladding formed during identical molding process when with deflectionable part (628) are formed moulds features.In view of this The teaching content of text, for constructing the other materials of latch (650) and being used to form the other modes of latch (650) for ability It will be apparent for the those of ordinary skill of domain.

Latch (650) includes the hook component (652) on the either side of latch (650).Each hook component (652) is relative to anvil The longitudinal axis of seat (618) orthogonally extends outwardly from latch (650).Each hook component (652) includes being located at its end End (654).Each end (654) is configured to undercut feature portion (646) engagement corresponding to storehouse (637), as shown in figure 18. This engagement provides the selective interlock between anvil block (618) and storehouse (637).In elastomer latch (650) and hook component (652) have under elastic characteristic, when being closed end effector (612) so that anvil block (618) is engaged with storehouse (637), hook component (652) it can be deflected when contacting the end wall of recessed portion (638).This deflection will allow anvil block (618) to continue to be closed and allow hook Component (652) engagement in undercut feature portion (646).In this example, each hook component (652) includes chamfering (656), first Contact the side wall of recessed portion (638) first to promote hook component (652) gradually when engaging anvil block (618) with storehouse (637) Deflection.

If shown and describing in this example, the width of latch (650) can be defined as the end from a hook component (652) Distance of the portion to the end of another hook component (652).Similarly, the width of recessed portion (638) can be defined as from recess One side wall (638) in portion arrives the distance of the opposing sidewalls (638) of recessed portion.In this example, the width of latch (650) is greater than The width of recessed portion (638).However, undercut feature portion (646) can provide the additional width in recessed portion (638).In addition, door bolt The hook component (652) for locking the elastic characteristic latch enable (650) of (650) is deformed inward, so that closing in end effector (612) The width of latch (650) be can reduce during conjunction to allow hook component (652) to engage with undercutting component (646).In engagement, door bolt The width of lock (650) may return to its original width, thus promote the secured but selection between anvil block (518) and storehouse (637) The connection of property.

From bonding station as shown in figure 18, anvil block (618) can be enough to overcome hook component (652) bias by providing Opening force is separated with storehouse (637), so that they deform and are detached from the undercut feature portion (646) of storehouse (637).As substitution or Supplement, anvil block (618) can be separated by providing the opening force for being enough to make distal end (619) to deflect with storehouse (637), so that Hook component (652) and undercut feature portion (646) are detached from.For example, hook component (652) and the rest part of distal end (619) Deformability may be configured so that the rest part than distal end (619) is easier to deflect by hook component (652).At this In configuration, hook component (652) will deflect first so that anvil block (618) and storehouse (637) are detached from.In contrast, hook component (652) and The deformability of the rest part of distal end (619) may be configured so that hook component (652) will be than distal end (619) The more difficult deflection of rest part.In the configuration, the part other than hook component (652) of distal end (619) will It is deflected first be finally detached from anvil block (618) and storehouse (637).In addition, remaining of hook component (652) and distal end (619) Partial deformability may be configured so that hook component (652) will be easy as the rest part of distal end (619) Deflection.In the configuration, two parts of distal end (619) and hook shape component (652) will all be deflected finally to make anvil block (618) it is detached from storehouse (637).

As described above, and as shown in Figure 18 and Figure 19, interlocking features portion be configured so that undercut feature portion (646) and Engagement between the hook component (652) of latch (650) is orthogonally positioned relative to the longitudinal axis of storehouse (637).In other words, it fastens with a bolt or latch The hook component (652) for locking (650) is laterally extended far from the longitudinal axis of storehouse (637).Similarly, recessed portion (638) longitudinally extends, And undercut feature portion (646) orthogonally extend relative to the longitudinal axis of storehouse (637).Therefore, undercut feature portion (646) are by hook structure Part (652) from transverse direction or be generally normal to the longitudinal axis limited by storehouse (637) direction engage.When anvil block (618) with When storehouse (637) separates, it is detached from opposite way as described above generation, and this disengaging is by being generally normal to storehouse (637) Longitudinal axis occur deflection and occur.

The anvil block (618) of end effector (612) further includes gap setting features (658).Gap setting features (658) proximal end of distally located end (619).Gap setting features (658) are sized so that when end is held When row device (612) is in closed configuration as shown in figure 18, it contacts the surface towards anvil block of storehouse (637).In addition, working as gap When features (658) contact storehouse (637) are arranged, the corresponding undercutting of end (654) contact of the hook component (652) of latch (650) is special The top surface (648) in sign portion (646).In this way, when anvil block (618) is engaged with storehouse (637), anvil block (618) into one Step closure is limited by gap setting features (658).In the shown example of Figure 18 and Figure 19, gap setting features It (658) include rectangular beam shape；However, content in view of the teachings contained herein, the other shapes of gap setting features (658) and match Setting will be apparent to those of ordinary skill in the art.

C. with the anvil block of deformable end and tissue stabilization features

In some cases, include the case where the anvil block for combining angled and deformable distal end in end effector Under, features can be integrated in the distal end of anvil block, this facilitates anvil block and storehouse of the stable holding in end effector Between tissue.When the regulation that end effector is used to be related to advancing, these tissue stabilization features may be particularly useful.It is special Not, stabilizing tissue is to ensure that currently cutting executes as expected and the projection for cutting in sequence next time is kept to cut simultaneously Line may be helpful.Additionally, tissue stabilization features can be made of the elastomeric material of elastically deformable.Same The combination that tissue stabilization features are provided on angled and deformable anvil block end, which can provide, to be improved tissue capture and keeps Mode, while also providing the mode for handling captured tissue, due to anvil block distal end and tissue stabilization features can Deformation behaviour portion and have lesser tissue trauma chance.

Figure 20 shows the amplifier section of the distal end of another exemplary anvil (718) of end effector, wherein anvil block (718) tissue stabilization features (714) are combined.Anvil block (718) includes main body (730) and the distal side connecting with main body (730) end It holds (719).It should be appreciated that anvil block (718) can be matched with lower jaw (16) and storehouse (37) to be such as instrument (10,310) Instrument provide end effector.Similarly, anvil block (718) is substituted for the anvil block (18) in end effector (12), Or the anvil block (218) in replacement end effector (212), or replace the anvil block (318) in end effector (312,412).

In this example, tissue stabilization features (714) are configured in the distal end (719) of anvil block (718) Two arcuate ridges of far-end.In other patterns, tissue stabilization features (714) more or less can be used. In addition, tissue stabilization features (714) can be configured with along the downside surface (724) of anvil block (718) in other patterns Alternative form or position.

Tissue stabilization features (714) are further formed as one of the deflectionable part (728) of distal end (719) Point.In this example, deflectionable part (728) and tissue stabilization features (714) are formed by elastomeric material.In addition, tissue Invariant feature portion (714) can be formed in molding process during the remainder for forming deflectionable part (728).For this purpose, Form slit (749) prevents elastomeric material from entering the slit of anvil block (718) to receive stopper element (not shown).It utilizes Shown and described this configuration, anvil block (718) are equipped with angled deformable distal end (719), have one A or multiple elastic fibrous tissue invariant feature portions (714).Content in view of the teachings contained herein, for elastic fibrous tissue invariant feature portion (714) other configurations of the angled and deformable distal end (719) of anvil block (718) are for those of ordinary skill in the art For be obvious.

IV. with the bending elastically deformable anvil block end of rigid end

As discussed above, in some cases, it can be possible to which being desired for user provides the modification of end effector (12,212), The modification provides the traveling ability of end effector (12), improvement associated with end effector (212) visuality, Yi Jiduan Tissue collecting's function of portion's actuator (212), otherwise may be with the perfect rigidity pattern of end effector (212) without will increase Associated wound risk.In some cases, it can be possible to be intended to provide angled and deformable anvil block end, while also keeping The rigid distal of anvil block.Using this configuration, end effector, which can be provided in, has dissection end in end effector configuration Additional benefits provide the visualization/navigability and tissue collecting's ability enhanced as described above.In addition to this or as another A kind of outer selection, providing rigid element in the distal end of end effector can contribute to for end effector to be inserted into narrow sky Between, expansion opening etc..While such ability is provided, it is also possible to it is desirable to keep that at least a degree of elasticity is to allow to ring It should be deformed in significant transverse load.

A. with the anvil block of thin contour nasal portion nasal portion

Figure 21 and Figure 22 shows the exemplary anvil (818) for end effector.It should be appreciated that anvil block (818) can To match with lower jaw (16) and storehouse (37) so that the instrument for such as instrument (10,310) provides end effector.Similarly, Anvil block (818) is substituted for the anvil block (18) in end effector (12), or replaces the anvil block in end effector (212) (218), or instead of the anvil block (318) in end effector (312,412).Anvil block (818) includes main body (830) and bending distal side End (819).Anvil block (818) further includes nail shapes pit (846) and slit (844), is structurally and functionally similar to Nail shapes pit (53) described above and slit (49).

In this example, main body (830) includes the metal material of rigid construction.Distal end (819) are bent from main body (830) distally extending.Bending distal end (819) includes elastomeric pad (816), nasal portion nasal portion (820) and distal end (822).Nasal portion nasal portion (820) connect with main body (830) and from its extend and metal construction material having the same.Far End (822) connect with nasal portion nasal portion (820) and from its extension and also metal construction material having the same.With this side Formula, nasal portion nasal portion (820) and distal end (822) can be considered as a part for being formed as being bent distal end (819) Main body (830) extension.Nasal portion nasal portion (820) includes allowing and promoting the nasal portion nasal portion of anvil block (820) (818) thin contour of deflection.In this example, nasal portion nasal portion (820) limits deflecting region.Distally (822) include thick wheel Exterior feature, so that distal end (822) is rigid, and any deflection of distal end (822) is all due to the nasal portion nasal portion (820) Deflection caused by.In this way, distal end (822) can operationally be configured for anatomical tissue or blood vessel.

Elastomeric pad (816) is connect with the downside surface of nasal portion nasal portion (820).This connection can by chemistry or Mechanical system is realized；And content in view of the teachings contained herein, those skilled in the art will appreciate that (816) and anvil block will be padded The various modes of rest part (818) connection.In some patterns, elastomeric pad (816) is bonded to anvil using molding process Seat (818).In such example, the downside (820) of nasal portion nasal portion may include be configured to during molding with pad (816) it engages so that the structure feature portion that (816) are fixed to anvil block (818) thus will be padded.Only as an example, not a limit, anvil block (818) rigid element similar with rigid element (326) of anvil block (318) can be configured with.In such an example, it pads (816) it can be coated and be moulded with rigid element, the cladding for being similar to deflectionable part (328) to rigid element (326) moulds, such as Above with respect to shown in Figure 13 to Figure 15 and described.For this purpose, formed slit (849) with receive stopper element (not shown) with Just prevent elastomeric material from entering the slit (844) of anvil block (818).

In another pattern of anvil block (818), main body (830), nasal portion nasal portion (820) and distal end (822) can be with By another suitable material construction in addition to metal material.As an example, not a limit, content in view of the teachings contained herein, other Suitable material may include various plastics, and will be apparent to practitioners skilled in the art other materials. Therefore, although above-mentioned example describes the metal construction of main body (830), nasal portion nasal portion (820) and distal end (822), anvil The construction of seat (818) should not necessarily be limited by metal construction.

B. with the anvil block of elastomeric insert

Figure 23 and Figure 24 shows the exemplary anvil (918) for end effector.It should be appreciated that anvil block (918) can To match with lower jaw (16) and storehouse (37) so that the instrument for such as instrument (10,310) provides end effector.Similarly, Anvil block (918) is substituted for the anvil block (18) in end effector (12), or replaces the anvil block in end effector (212) (218), or instead of the anvil block (318) in end effector (312,412).Anvil block (918) includes main body (930) and bending distal side End (919).Anvil block (918) further includes nail shapes pit (946) and slit (944), is structurally and functionally similar to Nail shapes pit (53) described above and slit (49).

In this example, main body (930) includes the metal material of rigid construction.Distal end (919) are bent from main body (930) distally extending.Bending distal end (919) include elastomeric insert (916), nasal portion nasal portion (920) and far It holds (922).Nasal portion nasal portion (920) connect with main body (930) and from its extend and metal construction material having the same. Distally (922) connect with nasal portion nasal portion (920) and extend from it and also metal construction material having the same.With this Mode, nasal portion nasal portion (920) and distal end (922) can be considered as being formed as being bent one of distal end (919) The extension for the main body (930) divided.Nasal portion nasal portion (920) includes prolonging from the top surface (926) of nasal portion nasal portion (920) Reach the opening (948) of the downside surface (924) of nasal portion nasal portion (920).Elastomeric insert (916) is configured so that It is assemblied in opening (948) and fills the opening, and this configuration allows and promotes the nasal portion nasal portion of anvil block (920) (918) deflection.In this example, elastomeric insert (916) limits deflecting region.Distally (922) include thick profile, so that far End (922) is rigid, and any deflection of distal end (922) is all since the nasal portion nasal portion (920) is around elasticity Caused by the deflection of body insertion piece (916).In this way, distal end (922) can operationally be configured for anatomical tissue Or blood vessel.In addition, the downside surface (924) of nasal portion nasal portion (920) is adjacent with elastomeric insert (916) distal side.Downside It is that surface (924) is generally planar and be transitioned into distal end (922), shown with chamfering surface.With this configuration, downside table Face (924) can provide the Additional contact zones beyond distal end (922) for anatomical tissue or blood vessel.It should be appreciated that insertion Part (916) can be molded or can be formed as the one or more discrete items for being subsequently incorporated into anvil block (918).

As mentioned, in the nasal portion nasal portion (920) of elastomeric insert (916) filling bending distal end (919) Opening (948).Chemically or mechanically fastening can be used to connect nasal portion nasal portion (920) in elastomeric insert (916).Mirror In teaching herein content, those skilled in the art will appreciate that even by the rest part (918) of insertion piece (916) and anvil block The various modes connect.In some patterns, elastomeric insert (916) is bonded to anvil block (918) using molding process.For This, form slit (949) prevents elastomeric material from entering the slit of anvil block (918) to receive stopper element (not shown) (944).It is also understood that nasal portion nasal portion (920) opening (948) may include be configured to during molding with insertion Part (916) engagement is with the various structure feature portions thus by insertion piece (916) fixed to anvil block (918).

In another pattern of anvil block (918), main body (930), nasal portion nasal portion (920) and distal end (922) can be with By another suitable material construction in addition to metal material.As an example, not a limit, content in view of the teachings contained herein, other Suitable material may include various plastics, and will be apparent to practitioners skilled in the art other materials. Therefore, although above-mentioned example describes the metal construction of main body (930), nasal portion nasal portion (920) and distal end (922), anvil The construction of seat (918) should not necessarily be limited by metal construction.

C. for improving the anvil block with connecting elements of deformability

Figure 25 and Figure 26 shows the exemplary anvil (1018) for end effector.It should be appreciated that anvil block (1018) It can be matched with lower jaw (16) and storehouse (37) to provide end effector for the instrument of such as instrument (10,310).It is similar Ground, anvil block (1018) is substituted for the anvil block (18) in end effector (12), or replaces in end effector (212) Anvil block (218), or replace the anvil block (318) in end effector (312,412).Anvil block (1018) includes main body (1030), curved Bent distal end (1019) and connecting elements (1016).Anvil block (1018) further includes nail shapes pit (1046) and slit (1044), nail shapes pit described above (53) and slit (49) are structurally and functionally similar to.

In this example, main body (1030) includes the metal material of rigid construction.Connecting elements (1016) is from main body (1030) distally extending and including same metal building material.Be bent distal end (1019) from connecting elements (1016) to Distal side extends, and further includes same metal building material.Bending distal end (1019) includes nasal portion (1020) and distal end (1022).Nasal portion (1020) connect with connecting elements (1016) and extends from it.Distally (1022) and nasal portion (1020) connect It connects and extends from it.With this configuration, being bent distal end (1019) and connecting elements (1016) can be considered as leading The extension of body (1030).Connecting elements (1016) includes the thin contour for allowing and promoting the deflection of nasal portion (1020).At this In example, connecting elements (1016) limits the deflecting region for being bent distal end (1019).It is bent distal end (1019) packet Thick profile is included, so that nasal portion (1020) and distal end (1022) are rigid, and its any deflection is due to as described above around company Caused by the deflection of connection member (1016).By being bent the thicker profile of distal end (1019), distal flex end (1019) anatomical tissue or blood vessel can be operationally configured for.

Other than thin contour, connecting elements (1016) further includes that can promote or improve bending distal end (1019) The additional function of deformability.One such features includes connecting elements (1016) relative to bending distal end (1019) Main body (1030) and nasal portion (1020) width narrower width.Be configured to improve bending distal end (1019) can Another features of morphotropism include the slit (1048) longitudinally extended along the middle line of connecting elements (1016).Slit (1048) and the narrower width of connecting elements (1016) is all arranged to reduce the rigidity of connecting elements (1016), so that connection structure Part (1016) by from clamping or otherwise contact tissue power when can be easier deflect, as shown in figure 26.Mirror In teaching herein content, improve the other modes pair of deformability for modifying connecting elements (1016) to remove material It will be apparent for those of ordinary skill in the art.

In another pattern of anvil block (1018), one or more main bodys (1030), bending distal end (1019) and/ Or connecting elements (1016) can be constructed by another suitable material in addition to metal material.As an example, not a limit, it reflects In teaching herein content, other suitable materials may include various plastics, and for those of ordinary skills It is obvious other materials.Therefore, although above-mentioned example describes main body (1030), bending distal end (1019) and connects The metal construction of connection member (1016), but the construction of anvil block (1018) should not necessarily be limited by metal construction.

D. with the anvil block of integrated resiliency body engagement pad and rigid end

Figure 27 and Figure 28 shows the exemplary anvil (1118) for end effector.It should be appreciated that anvil block (1118) It can be matched with lower jaw (16) and storehouse (37) to provide end effector for the instrument of such as instrument (10,310).It is similar Ground, anvil block (1118) is substituted for the anvil block (18) in end effector (12), or replaces in end effector (212) Anvil block (218), or replace the anvil block (318) in end effector (312,412).Anvil block (1118) includes main body (1130) and curved Bent distal end (1119).Anvil block (1118) further includes nail shapes pit (1146) and slit (1144), in structure and function Can on similar to nail shapes pit described above (53) and slit (49).

In this example, main body (1130) includes the metal material of rigid construction.Distal end (1119) are bent from main body (1130) distally extending.Bending distal end (1119) includes elastomeric pad (1116), nasal portion (1120) and distal end (1122).Nasal portion (1120) connect with main body (1130) and from its extend and metal construction material having the same.Nose (1120) are divided to be configured with narrower width compared with the width of the width of main body (1130) or elastomeric pad (1116).Such as Figure 28 Shown, nasal portion (1120) further includes multiple recesses (1148) that the width across nasal portion (1120) is laterally extended.With nose (1120) are divided to extend to distal end, recess (1148) is configured to various sizes.For example, the recent side recess in shown pattern is matched It is set to maximum recess, farthest side recess is configured to minimum recess.The size of control recess (1148) can improve bending distal side The deformability of end (1119).

Distally (1122) connect with nasal portion (1120) and extend from it and also metal construction material having the same.With This mode, nasal portion (1120) and distal end (1122) can be considered as being formed as being bent one of distal end (1119) The extension for the main body (1130) divided.Shown in example as shown, distal end (1122) width substantially with nasal portion (1120) Width matches.In this way, nasal portion (1120) and distal end (1122) be all configured with the width of main body (1130) or The width of elastomeric pad (1116) compares narrower width.Distally (1122) further provide metal distal side for anvil block (1118) and connect Touch area.

In this example, elastomeric pad (1116) is overmolded on nasal portion (1120).In the cladding molding process phase Between, the elastomeric material of pad (1116) fills the space limited by multiple recesses (1148), and along nasal portion (1120) Side extends.Under the molded state that it is completed, elastomeric pad (1116), which is configured so that, keeps nasal portion (1120) and remote The exposed region of (1122) is held, these exposed regions are protruded relative to elastomeric pad (1116), shown in example as shown.In view of Teaching herein content can carry out nasal portion (1120) to provide and exceed notch (1148) for coating molded elastomeric Padding other additional or other structures features various modifications of (1116) will be aobvious to those skilled in the art And it is clear to.In some patterns, tissue stabilization features can be molded into elastomeric pad (1116).For example, this class loading It invariant feature portion can be same or similar with above-mentioned tissue stabilization features (714).However, content in view of the teachings contained herein, is used It will be apparent for those of ordinary skills in the other configurations and method for providing tissue stabilization features.

In another pattern of anvil block (1118), main body (1130) and bending distal end (1119) can be by removing metal Other suitable materials construction except material.As an example, not a limit, content in view of the teachings contained herein, other suitable materials It may include various plastics, and will be apparent to practitioners skilled in the art other materials.Therefore, although on It states example and describes the metal construction of main body (1130), nasal portion (1120) and distal end (1122), but the construction of anvil block (1118) It should not necessarily be limited by the metal construction of these components.

V. with the end effector of elastically deformable storehouse end

In some cases, when it is expected straight and rigid anvil block, hurtless measure end is used for modifying end effector Another method of end enhancing visualization, operability and collection tissue includes adding elastomer bent back ends to the distal end in storehouse. In this way, when end effector is closed and when being manipulated to operative site, the elastomer bent back ends added on the distal end of storehouse Otherwise filling will be present in the space of the far-end of end effector.By make end effector move through and along tissue when The distal end for making tissue deviate end effector is helped, this configuration can reduce the resistance of far-end when manipulating end effector Power.

Figure 29 to Figure 31 shows exemplary end effector (1212) or its component, in conjunction with being attached to storehouse (1237) The elastomer bent back ends (1214) of distal end.In addition to bent back ends (1214) and storehouse (1237), end effector (1212) is also wrapped Include lower jaw (16) and anvil block (1218).Lower jaw (16) is configured to receive storehouse (37) with lower jaw as described above (16) The same or similar mode receives storehouse (1237).Anvil block (1218) is similar to above-mentioned anvil block (18), but has and be similar to anvil block It (218) but is straight rather than curved sharper distal end.Storehouse (1237) is similar to storehouse as described above (37), the difference is that In conjunction with elastomer bent back ends (1214).As shown in figure 29, storehouse (1237) further include the upper mounting plate (1272) positioned at storehouse (1237) On tissue gripping features portion (1216).This tissue gripping features portion (1216) is optional feature portion and in other patterns It can be omitted them.

As described above, the angled distal attachment of elastomer bent back ends (1214) and storehouse (1237).Bent back ends (1214) chemically or mechanically fastening can be used with the connection of storehouse (1237) to realize.Content in view of the teachings contained herein, this field Ordinarily skilled artisan will understand that the various modes that bent back ends (1214) are connect with the distal end of storehouse (1237).In some patterns In, bent back ends (1214) are bonded to storehouse (1237) using molding process.In such example, the distal end of storehouse (1237) can be with Including various structure feature portions, it is configured to engage during molding with the elastomeric material of bent back ends (1214) with thus Bent back ends (1214) are fixed to the distal end of storehouse (1237).In this example, bent back ends (1214) be resiliently biased with from The angled distal face in storehouse (1237) essentially perpendicularly extends, it is to be understood that, bent back ends (1214) can be with storehouse (1237) Angled distal face have any other suitable angular relationship.In addition, bent back ends (1214) be resiliently biased with along Extend in this example relative to the plane of the longitudinal axis tilted alignment of end effector (1212).

Bent back ends (1214) include lower lip (1220), upper lip (1222) and separator (1224).Under as described above, The angled distal attachment of antelabium (1220) and storehouse (1237).Upper lip (1222) extends from the portions of proximal of lower lip (1220) And it is connected thereto.Separator (1224) extends vertically from lower lip (1220) and connects lower lip (1220) and upper lip (1222).In this example, upper lip (1222) includes top surface (1226), which includes gripping features portion (1228), The gripping features portion, which is configured to improve, is clamped in the tissue clamped between anvil block (1218) and storehouse (1237), such as such as Figure 31 institute Show.

Referring to Figure 30 and Figure 31, end effector (1212) is each shown as being in and close when not clamping tissue and clamping tissue Coincidence is set.As shown, when in the close position in any case, distal end and the distal end of storehouse (1237) of anvil block (1218) Lengthwise position alignment.In other patterns, end effector (1212) be may be configured so that when end effector (1212) When closure, the distal end of anvil block (1218) extends past storehouse (1237).Still in other patterns, end effector (1212) can be with Be configured so that when end effector (1212) closure when, the distal end for ending remotely at storehouse (1237) of anvil block (1218) it is close Side.

As shown in figure 31, when tissue (90) is trapped between anvil block (1218) and storehouse (1237), elastomer bending end (1214) are held to be deformed to closed state shown in Figure 31 from its opening state in Figure 30.Under this deformation state, upper lip (1222) downwardly lower lip (1220) deflects.In addition, separator (1224) is by compression and lateral deflection.As shown in figure 31, In its deformation state, the upper lip (1222) of bent back ends (1214) extends to the distal side of anvil block (1218) and storehouse (1237). When tissue is clamped between end effector (1212), cutting and stitch sequence now may be to hold with above with respect to end Similar mode end effector (1212) Lai Jinhang of the mode of row device (12) description.When discharging chucking power, bent back ends (1214) configuration shown in Figure 29 to Figure 30 can be returned resiliently to and be orientated.

Content in view of the teachings contained herein, it should be understood that end effector (1212) can be used and replace as described herein What his end effector.It is, for example, possible to use end effector (1212) to replace end effector shown in FIG. 1 (12), or Instead of end effector shown in Figure 11 (312).In some patterns, end effector (1212) can be with axis (22,322) one It is formed；Alternatively, it may be separately formed end effector and then assembled.In some patterns, as set forth above, it is possible to provide End effector (1212) is to be used for robot system.

VI. example combinations

Following embodiment is related to the various non-exclusive modes that teaching herein content can be combined or apply.It should manage Solution, following embodiment be not intended to limit can present patent application or present patent application it is subsequent present a paper in any time The coverage area of any claim provided.It is not intended to carry out disclaimer.Following embodiment is provided merely for the sake of illustration Property purpose.It is expected that the various teaching content of this paper can be arranged and apply in number of other ways.It is contemplated that arriving, some modifications Certain features mentioned in following embodiment can be omitted in.Therefore, any one of aspect or feature mentioned below be not Should be considered as conclusive, unless in addition for example by inventor or pay close attention to inventor successor the date later clearly indicate as This.If present patent application or any claim of subsequent middle proposition of presenting a paper relevant to present patent application include hereafter Those of refer to the supplementary features except feature, then these supplementary features should not be assumed because of any original relevant to patentability Thus it is added.

Embodiment 1

A kind of equipment, comprising: (a) main body；(b) axis, the axis extend from main body, wherein axis limit longitudinal axis；And (c) End effector, the end effector are connected to axis, and end effector can be operated with compression, suture and cutting tissue, Its end effector includes: the storehouse (i), which is configured to keep one or more nails, and (ii) anvil block, which can be opposite Moved between the open position and the closed position in storehouse, and (iii) be bent distal end, the bending distal end be located at storehouse or The far-end of anvil block, wherein bending distal end includes elastically deformable part, which is configured to respond to Make at least part deflection for being bent distal end in the chucking power for being applied to bending distal end.

Embodiment 2

According to equipment described in embodiment 1, wherein when bending distal end is not subject to chucking power, be bent distal end It is biased to keep undeformed state.

Embodiment 3

According to any one of embodiment 1 to 2 or the multinomial equipment, wherein bending distal end is included in bending Distal end limits the downside surface of the first plane when being in non-deformed state, wherein first angle is flat with first by longitudinal axis The intersection in face limits, and wherein downside surface limits the second plane when being bent distal end and being in deformation state, wherein second jiao Degree is limited by longitudinal axis and the intersection of the second plane.

Embodiment 4

According to equipment described in embodiment 3, wherein first angle is being in about 20 degree to about towards the upper in downward direction of storehouse In the range of 50 degree, and wherein second angle far from storehouse upward direction on be in about 10 degree to about 30 degree in the range of.

Embodiment 5

According to any one of embodiment 3 to 4 or the multinomial equipment, wherein bending distal end is configured to from bullet Property displacement pass through the motion range in the range of from about 30 degree to about 80 degree.

Embodiment 6

According to any one of embodiment 1 to 5 or the multinomial equipment, wherein the bending distal end of anvil block include from The rigid element that the main body of anvil block extends towards distal side, wherein elastically deformable part is overmolded on rigid element.

Embodiment 7

According to equipment described in embodiment 6, wherein rigid element includes the opening for extending through rigid element, wherein can The material of elastic part is located in opening.

Embodiment 8

According to any one of embodiment 1 to 7 or the multinomial equipment, wherein the bending distal end of anvil block includes position One or more tissue stabilization features on the downside surface of bending distal end.

Embodiment 9

According to any one of embodiment 1 to 8 or the multinomial equipment, wherein the bending distal end of anvil block includes the One engagement feature, wherein storehouse includes the second engagement feature, wherein the first engagement feature and the second engagement feature are matched Engagement is set to provide interlocking features portion for end effector.

Embodiment 10

According to equipment described in embodiment 9, wherein the first engagement feature includes the downside surface with bending distal end The latch of connection, and wherein the second engagement feature includes the recessed portion formed on the distal end in storehouse.

Embodiment 11

According to equipment described in embodiment 10, wherein latch includes hook component, and wherein recessed portion includes undercut feature portion, Wherein hook component is configured to be selectively engaged with undercut feature portion.

Embodiment 12

According to equipment described in embodiment 11, wherein hook component and undercut feature portion are machine-direction oriented relative to anvil block and storehouse.

Embodiment 13

According to equipment described in embodiment 11, wherein hook component and undercut feature portion are relative to anvil block and storehouse horizontal orientation.

Embodiment 14

According to any one of embodiment 1 to 13 or the multinomial equipment, wherein between the bending distal end of anvil block includes Features are arranged in gap, and gap setting features are configured to keep downside surface and the storehouse of bending distal end when anvil block is closed Between expectation spacing.

Embodiment 15

According to any one of embodiment 1 to 14 or the multinomial equipment, wherein storehouse includes the surface in distal side, The surface in distal side in middle storehouse is obliquely orientated relative to the longitudinal axis limited by end effector, wherein bending distal side end End extends from the surface in distal side in storehouse towards distal side.

Embodiment 16

A kind of equipment, comprising: (a) main body；(b) axis, the axis extend from main body, wherein axis limit longitudinal axis；And (c) End effector, the end effector are connected to axis, and end effector can be operated with compression, suture and cutting tissue, Its end effector includes: the storehouse (i), which is configured to keep one or more nails, and (ii) anvil block, which can be It is moved between open position and closed position, wherein anvil block includes bending distal end, wherein bending distal end includes can bullet Property deformed part, which is configured in response to be applied to the chucking power of bending distal end and keeps bending remote At least part of side end deflects, and wherein bending distal end includes operationally be configured for anatomic tissue rigid Property distal end.

Embodiment 17

According to equipment described in embodiment 16, wherein bending distal end includes nasal portion, which is connected to anvil block Main body and extend from the main body of the anvil block and be connected further to rigid distal, wherein bending distal end further includes and nose The elastomeric elements of part connection.

Embodiment 18

According to any one of embodiment 16 to 17 or the multinomial equipment, wherein bending distal end includes nasal portion, The nasal portion is connected to the main body of anvil block and extends from the main body of the anvil block and be connected further to rigid distal, wherein nose Dividing includes the multiple recesses reduced in nasal portion towards size when the extension of distal side, and plurality of recess is configured to receiving and nasal portion Coat the elastomeric material of molding.

Embodiment 19

According to any one of embodiment 16 to 18 or the multinomial equipment, wherein bending distal end includes nasal portion, The nasal portion is connected to the connecting elements of anvil block and is connected further to rigid distal, and wherein connecting elements includes relative to phase The narrow width of adjacent nasal portion and adjacent anvil body, wherein connecting elements further includes extending to connection structure from the end of connecting elements The slit of the opposed end of part.

Embodiment 20

A kind of equipment, comprising: (a) main body；And (b) end effector, the end effector are connected to main body, end is held Row device includes: (i) anvil block, and (ii) lower jaw, wherein anvil block can be mobile towards lower jaw, and the storehouse (ii), which can be removed Ground is received in lower jaw, and wherein storehouse can be operated to drive and follow closely towards anvil block, and wherein storehouse includes distal end and connect with distal end The bent back ends of elastically deformable, wherein the bent back ends of elastically deformable include deformable upper lip, the first of separator The deformable separator that end is connect with upper lip and the lower lip being connect at the second end of separator with separator Edge.

VII. miscellaneous

It should be appreciated that any one or more of teachings described herein content, expression, embodiment, example etc. can It is combined with any one or more of other teaching content as described herein, expression, embodiment, example etc..Therefore, Above-mentioned teaching content, expression, embodiment, example etc. are not construed as isolating each other.With reference to teaching herein content, the religion of this paper The various suitable methods that leading content can be combined will be evident for the ordinary skill in the art.Such modification It is intended to include within the scope of the claims with modification.

It is also understood that teaching herein content can easily with the various teaching content groups in following U.S. Patent application It closes: U.S. Patent application [attorney number END8113USDP.0641895], entitled " Surgical Stapler End Effector with Varying Deck Height and Tissue Gripping Features ", on the same day with the application It submits, the disclosure of which is herein incorporated by reference.Teaching herein content can be with U.S. Patent application [agent File number END8113USDP.0641895] the various suitable methods that are combined of teaching content for this field common skill It will be apparent for art personnel.

It is also understood that teaching herein content can easily with the various teaching content groups in following U.S. Patent application It closes: U.S. Patent application [attorney number END8114USDP.0641876], entitled " Circular Surgical Stapler End Effector with Varying Deck Height and Tissue Gripping Features ", It is submitted on the same day with the application, the disclosure of which is herein incorporated by reference.Teaching herein content can be special with the U.S. The various suitable methods that the teaching content of benefit application [attorney number END8114USDP.0641876] is combined are for this It will be apparent for the those of ordinary skill in field.

It is also understood that teaching herein content can easily with the various teaching content groups in following U.S. Patent application It closes: U.S. Patent application [attorney number END8116USNP.0641882], entitled " Surgical Stapler with Insertable Distal Anvil Tip ", is submitted, the disclosure of which is incorporated by reference on the same day with the application Herein.Teaching herein content can in the introduction of U.S. Patent application [attorney number END8116USNP.0641882] Holding the various suitable methods being combined will be obvious to those of ordinary skill in the art.

It is also understood that teaching herein content can easily with the various teaching content groups in following U.S. Patent application It closes: U.S. Patent application [attorney number END8117USNP.0641884], entitled " Surgical Stapler with Cooperating Distal Tip Features on Anvil and Staple Cartridge ", mentions on the same day with the application It hands over, the disclosure of which is herein incorporated by reference.

Teaching herein content can be with the introduction of U.S. Patent application [attorney number END8117USNP.0641884] The various suitable methods that content is combined will be obvious to those of ordinary skill in the art.

It is also understood that teaching herein content can easily with the various teaching content groups in following U.S. Patent application It closes: U.S. Patent application [attorney number END8118USDP.0641887], entitled " Surgical Stapler with Bent Anvil Tip and Angled Staple Cartridge Tip ", is submitted, the disclosure of the patent on the same day with the application Content is herein incorporated by reference.Teaching herein content can be with U.S. Patent application [attorney number END8118USDP.0641887] the various suitable methods that are combined of teaching content for those of ordinary skill in the art For will be apparent.

It is also understood that teaching herein content can easily with the various teaching content groups in following U.S. Patent application It closes: U.S. Patent application [attorney number END8118USNP.0641889], entitled " Surgical Stapler with Bent Anvil Tip, Angled Staple Cartridge Tip, and Tissue Gripping Features ", with this Application is submitted on the same day, and the disclosure of which is herein incorporated by reference.Teaching herein content can be with United States Patent (USP) Shen The various suitable methods that please teaching content of [attorney number END8118USNP.0641889] is combined are for this field Those of ordinary skill for will be apparent.

It should be appreciated that it is said that any patent being herein incorporated by reference, patent disclosure or other public materials, no matter It is full text or part, only the existing definition described in incorporated material and the disclosure, statement or other public materials are not It is incorporated herein in the range of conflict.Therefore, and at the necessary level, disclosure specifically listed herein is replaced with reference Any conflict material that mode is incorporated herein.It is said that be herein incorporated by reference but with list herein existing definition, statement Or conflicting any material of other public materials or part thereof, it will be only between incorporated material and existing public material It does not generate and is incorporated under the degree of conflict.

The pattern of above-mentioned apparatus can be applied to the traditional medicine treatment and operation carried out by medical professional and machine In human-aided therapeutic treatment and operation.Only by way of example, the various teaching content of this paper can be easy to be incorporated to outside robot Section's system, such as Intuitive Surgical, the DAVINCI of Inc. (Sunnyvale, California)^TMSystem.It is similar Ground, those skilled in the art are it will be recognized that various teaching content herein can be easy to combine in following United States Patent (USP) Any one various teaching content: on August 11st, 1998 publication entitled " Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity The United States Patent (USP) 5 of and Sensitivity ", 792,135, the disclosure of which is herein incorporated by reference；1998 The beauty of entitled " the Remote Center Positioning Device with Flexible Drive " of publication on October 6 State's patent 5,817,084, the disclosure of which is herein incorporated by reference；On March 2nd, 1999 is issued entitled The United States Patent (USP) 5 of " Automated Endoscope System for Optimal Positioning ", 878,193, this is specially The disclosure of benefit is herein incorporated by reference；Entitled " the Robotic Arm DLUS for of publication on May 15th, 2001 The United States Patent (USP) 6 of Performing Surgical Tasks ", 231,565, the disclosure of which is incorporated by reference Herein；Entitled " the Robotic Surgical Tool with Ultrasound of publication on August 31st, 2004 The United States Patent (USP) 6 of Cauterizing and Cutting Instrument ", 783,524, the disclosure of which is to quote Mode is incorporated herein；Entitled " the Alignment of Master and Slave in a of publication on April 2nd, 2002 The United States Patent (USP) 6 of Minimally Invasive Surgical Apparatus ", 364,888, the disclosure of which with Way of reference is incorporated herein；Entitled " the Mechanical Actuator Interface of publication on April 28th, 2009 The United States Patent (USP) 7 of System for Robotic Surgical Tools ", 524,320, the disclosure of which is to quote Mode is incorporated herein；The U.S. of entitled " the Platform Link Wrist Mechanism " of publication on April 6th, 2010 is special Benefit 7,691,098, the disclosure of which is herein incorporated by reference；On October 5th, 2010 is issued entitled “Repositioning and Reorientation of Master/Slave Relationship in Minimally The United States Patent (USP) 7 of Invasive Telesurgery ", 806,891, the disclosure of which is herein incorporated by reference； Entitled " the Automated End Effector Component Reloading System that on January 10th, 2013 announces The U.S. of for Use with a Robotic System " announces 2013/0012957, and the disclosure of which is with the side of reference Formula is incorporated herein；On August 9th, 2012 entitled " the Robotically-Controlled Surgical announced The U.S. of Instrument with Force-Feedback Capabilities " announces 2012/0199630, the public affairs of the patent Content is opened to be herein incorporated by reference；Entitled " the Shiftable Drive Interface that on May 31st, 2012 announces The U.S. of for Robotically-Controlled Surgical Tool " announces 2012/0132450, the disclosure of the patent Content is herein incorporated by reference；On August 9th, 2012 entitled " the Surgical Stapling Instruments announced The U.S. of with Cam-Driven Staple Deployment Arrangements " announces 2012/0199633, the patent Disclosure be herein incorporated by reference；On August 9th, the 2012 entitled " Robotically-Controlled announced Motorized Surgical End Effector System with Rotary Actuated Closure Systems The U.S. of Having Variable Actuation Speeds " announces 2012/0199631, and the disclosure of which is to draw It is incorporated herein with mode；On August 9th, 2012 entitled " the Robotically-Controlled Surgical announced Announce 2012/ in the U.S. of Instrument with Selectively Articulatable End Effector " 0199632, the disclosure of which is herein incorporated by reference；It announces on August 9th, 2012 entitled The U.S. of " Robotically-Controlled Surgical End Effector System " announces 2012/0203247, The disclosure of which is herein incorporated by reference；On August 23rd, 2012 entitled " the Drive Interface announced It announces in the U.S. of for Operably Coupling a Manipulatable Surgical Tool to a Robot " 2012/0211546, the disclosure of which is herein incorporated by reference；On June 7th, 2012 announces entitled Announce 2012/ in the U.S. of " Robotically-Controlled Cable-Based Surgical End Effectors " 0138660, the disclosure of which is herein incorporated by reference；And/or it announces on August 16th, 2012 entitled “Robotically-Controlled Surgical End Effector System with Rotary Actuated The U.S. of Closure Systems " announces 2012/0205421, and the disclosure of which is herein incorporated by reference.

The device of pattern described above be designed to abandon after being intended for single use or they be designed to can be multiple It uses.In either case or in the case of two kinds, these patterns can be repaired to be repeated after use at least once It uses.Reparation may include any combination of following steps: provision for disengagement, then cleans or replaces specific component and then carry out It re-assemblies.Specifically, the device of detachable some patterns, and device can be selectively replaced or removed with any combination Any number of specific component or part.When cleaning and/or replacing particular elements, some patterns of described device can repaired It re-assemblies at multiple facility or is re-assemblied before it will be performed the operation by user for then using.The technology of this field Personnel will understand that the reparation of device can be dismantled using multiple technologies, clean/replace and re-assembly.Such technology Use and resulting prosthetic device within the scope of application.

Only by way of example, pattern described herein can sterilize before the surgery and/or later.In a kind of disinfection technology In, described device is placed in the container such as polybag or TYVEK bag of closure and sealing.Then container and device can be put It sets in the radiation field that can penetrate container, such as γ radiation, x-ray or high energy electron.Radiation can kill on device and in container Bacterium.Sterilized device can be then stored in sterile chamber, for using later.It also can be used known in the art Any other technology carries out disinfection to device, and the technology includes but is not limited to β radiation or γ radiation, ethylene oxide or steam.

Have been shown and elaborate various embodiments of the present invention, can without departing from the scope of the invention by Those skilled in the art are appropriately modified the further improvement to realize method described herein and system.It has mentioned And several such possible modifications, and other modifications for a person skilled in the art it will be evident that.On for example, It is required that embodiment, embodiment, geometry, material, size, ratio, the step etc. that text is discussed are illustrative rather than 's.Therefore, the scope of the present invention should consider according to following claims, and be interpreted as being not limited to the description and the appended drawings In the details structurally and operationally that shows and describe.

Claims

1. a kind of equipment, comprising:

(a) main body；

(b) axis, the axis extend from the main body, wherein the axis limit longitudinal axis；And

(c) end effector, the end effector are connected to the axis, wherein the end effector can be operated to press Contracting, suture and cutting tissue, wherein the end effector includes:

(i) storehouse, the storehouse are configured to keep one or more nails,

(ii) anvil block, the anvil block can move between the open position and the closed position relative to the storehouse, and

(iii) it is bent distal end, the bending distal end is located at the far-end of the storehouse or the anvil block, wherein described curved Bent distal end includes elastically deformable part, and the elastically deformable part is configured in response to be applied to the bending far The chucking power of side end and make it is described bending distal end at least part deflection.

2. equipment according to claim 1, wherein described when the bending distal end is not subject to the chucking power Bending distal end is biased to keep undeformed state.

3. equipment according to claim 1, wherein the bending distal end is included in the bending distal end and is in The downside surface of the first plane is limited when non-deformed state, wherein first angle is by the longitudinal axis and first plane Intersection limits, wherein the downside surface limits the second plane when the bending distal end is in deformation state, wherein the Two angles are limited by the longitudinal axis and the intersection of second plane.

4. equipment according to claim 3, wherein the first angle is in about towards the upper in downward direction of the storehouse In the range of 20 degree to about 50 degree, and wherein the second angle is in about 10 degree extremely in the upward direction far from the storehouse In the range of about 30 degree.

5. equipment according to claim 3, wherein the bending distal end is configured to move through from flexible deformation Motion range in the range of from about 30 degree to about 80 degree.

6. equipment according to claim 1, wherein the bending distal end of the anvil block includes from the anvil block The rigid element that main body extends towards distal side, wherein the elastically deformable part is overmolded on the rigid element.

7. equipment according to claim 6, wherein the rigid element includes extending through opening for the rigid element Mouthful, wherein the material of the elastically deformable part is located in the opening.

8. equipment according to claim 1, wherein the bending distal end of the anvil block includes being located at the bending One or more tissue stabilization features on the downside surface of distal end.

9. equipment according to claim 1, wherein the bending distal end of the anvil block includes the first engagement features Portion, wherein the storehouse includes the second engagement feature, wherein first engagement feature and the second engagement feature quilt Engagement is configured to provide interlocking features portion for the end effector.

10. equipment according to claim 9, wherein first engagement feature includes and the bending distal end Downside surface connection latch, and wherein second engagement feature includes the recess formed on the distal end in the storehouse Portion.

11. equipment according to claim 10, wherein the latch includes hook component, wherein the recessed portion includes bottom Features are cut, wherein the hook component is configured to be selectively engaged with the undercut feature portion.

12. equipment according to claim 11, wherein the hook component and the undercut feature portion are relative to the anvil block It is machine-direction oriented with the storehouse.

13. equipment according to claim 11, wherein the hook component and the undercut feature portion are relative to the anvil block With the storehouse horizontal orientation.

14. equipment according to claim 1, wherein the bending distal end of the anvil block includes gap setting spy Sign portion, the gap setting features are configured to keep the downside surface of the bending distal end when the anvil block is closed Expectation spacing between the storehouse.

15. equipment according to claim 1, wherein the storehouse includes the surface in distal side, wherein the storehouse is described Surface in distal side is obliquely orientated relative to the longitudinal axis limited by the end effector, wherein the bending distal side End extends from the surface for being in distal side described in the storehouse towards distal side.

16. a kind of equipment, comprising:

(a) main body；

(i) storehouse, the storehouse are configured to keep one or more nails, and

(ii) anvil block, the anvil block can move between the open position and the closed position, wherein the anvil block includes that bending is remote Side end, wherein the bending distal end includes elastically deformable part, the elastically deformable part is configured to respond to Make at least part deflection of the bending distal end in the chucking power for being applied to the bending distal end, and wherein The bending distal end includes the rigid distal for being operationally configured for anatomic tissue.

17. equipment according to claim 16, wherein the bending distal end includes nasal portion, and the nasal portion connects It is connected to the main body of the anvil block and extends and be connected further to the rigid distal from the main body of the anvil block, wherein described Being bent distal end further includes the elastomeric elements connecting with the nasal portion.

18. equipment according to claim 16, wherein the bending distal end includes nasal portion, and the nasal portion connects It is connected to the main body of the anvil block and extends and be connected further to the rigid distal from the main body of the anvil block, wherein described Nasal portion includes multiple recesses that size is reduced when the nasal portion extends towards distal side, wherein the multiple recess is configured to Receive the elastomeric material with nasal portion cladding molding.

19. equipment according to claim 16, wherein the bending distal end includes nasal portion, and the nasal portion connects Be connected to the connecting elements of the anvil block and be connected further to the rigid distal, wherein the connecting elements include relative to The narrow width of adjacent nose point and adjacent anvil body, wherein the connecting elements further includes prolonging from the end of the connecting elements Reach the slit of the opposed end of the connecting elements.

20. a kind of equipment, comprising:

(a) main body；And

(b) end effector, the end effector are connected to the main body, and the end effector includes:

(i) anvil block,

(ii) lower jaw, wherein the anvil block can be mobile towards the lower jaw, and the storehouse (ii), the storehouse are removedly received In the lower jaw, wherein the storehouse can operate with towards the anvil block drive follow closely, wherein the storehouse include distal end and with The bent back ends of the elastically deformable of the distal end connection, wherein the bent back ends of the elastically deformable include deformable upper lip Edge, the deformable separator being connect at the first end of separator with the upper lip and the second of the separator The lower lip that end is connect with the separator.